MassHealth ACO Transformation Stakeholder Engagement

Monday, September 10, 2018

Situation

Consumer and stakeholder engagement is crucial to cultivate acceptance and support when planning and developing new health policies and programs. An effective process solicits critical input and lays the groundwork for a collaborative relationship among all parties.

Challenges

The Massachusetts Medicaid program, MassHealth, needed to communicate with its stakeholders during its process to restructure into a value-based model as part a five-year 1115 Medicaid waver.

Solution

We worked with MassHealth to organize a stakeholder engagement process with one goal in mind: helping stakeholders move beyond individual perspectives to an informed, shared consensus.

Between August 2015 and February 2016, MassHealth sought stakeholder input on restructuring design through eight workgroups, each of which with 30-45 participants. The workgroups focused on strategic design, payment models, certification requirements, attribution, quality improvement, health homes, behavioral health, and long-term services and supports.

The groups represented more than 150 organizations and included consumers, providers, advocates, trade organization representatives and state agency staff. They met between six and nine times in the six-month period. Our team planned for and managed all meeting logistics, including securing venues, registering participants, and arranging for accommodations such as a CART reporter for each meeting and an ASL interpreter when needed. We also provided summary notes for each work group meeting.

Results

Output from the work groups we managed informed the development of MassHealth’s 1115 Medicaid waiver proposal, the centerpiece of which was a shift to a value-based delivery system using Accountable Care Organizations.

Our example also created a national standard for how implementation councils should work, and we continue to support MassHealth with its ACO implementation.