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Inflation Adjustment
  • CPI: adjusts for changes in the cost of goods and services purchased by consumers
  • IPD: adjusts for changes in the cost of goods and services purchased by governments
  • Economic Growth: adjusts for changes in the size of the state economy (measured in terms of total personal income)
  • None: does not capture changes in the value of a dollar over time.

MassHealth Managed Care

4000-0500

funding levels adjusted for inflation (CPI)

  • Funding History
  • Description
  • Proposals
Adjusted for inflation (CPI) NOT adjusted
FY19 GAA $5,759,010,341 $5,759,010,341
FY18 $5,689,489,743 $5,553,251,863
FY17 $5,676,269,753 $5,418,523,203
FY16 $6,330,567,768 $5,933,039,597
FY15 $5,148,302,006 $4,792,819,941
FY14 $4,868,844,888 $4,500,411,804
FY13 $4,483,956,070 $4,081,345,376
FY12 $4,333,488,036 $3,879,010,669
FY11 $4,532,463,291 $3,941,366,922
FY10 $4,222,180,409 $3,600,131,677
FY09 $3,663,841,690 $3,093,603,232
FY08 $3,526,737,707 $2,936,709,898
FY07 $3,138,856,168 $2,520,227,848
FY06 $2,913,928,304 $2,280,365,906
FY05 $3,075,500,821 $2,319,197,919
FY04 $3,224,513,412 $2,360,640,111
FY03 $2,648,236,232 $1,896,910,000
FY02 $2,487,579,453 $1,743,425,322
FY01 $2,164,530,122 $1,490,620,301
  • See Changes in Funding
Between and
Funding for MassHealth Managed Care
61.3%

comparisons adjusted for inflation (CPI)

Notes

  • Funding for MassHealth and related health reform programs often shifts among line item appropriations and special trust funds from year to year, so it is helpful to look at total funding, rather than at individual line items to get a sense of funding over time. In many years, the Administration has also been allowed to transfer funding among the MassHealth program line items without additional legislative approval. This means that there may be a meaningful difference between the budgeted amount and actual spending for individual line items, and that funding budgeted for one line item is ultimately spent in another.

MassHealth Managed Care pays for health insurance coverage provided to children and adults through several types of managed care health plans: Managed Care Organizations (MCOs), Primary Care Clinician Plans (PCCs), and Accountable Care Organizations beginning in March 2018 (ACOs). Most of the close to 640,000 children enrolled in MassHealth receive coverage through one of these managed health care plans.

Managed Care Organization (MCOs) are health plans that are run by insurance companies. Each MCO has its own network of providers such as doctors, specialists, and hospitals. A MassHealth member in an MCO must choose a primary care provider from within that network, and use the network's specialists and hospitals. A specific set of community partners provide behavioral health care and long-term care services.

The Primary Care Clinician Plan (PCC) is a statewide managed health care plan with its own network of primary care providers, specialists, and hospitals. The Massachusetts Behavioral Health Partnership provides behavioral health care.

Accountable Care Organizations (ACOs) are specific groups of health care providers such as doctors, hospitals, and others, who work together to coordinate care. One type of ACO works with managed care organizations (MCOs), and community partners provide behavioral health and long-term care services; the other type of ACO is called a primary care ACO, which is a group of primary care providers who work with specialists and hospitals in the MassHealth network. The Massachusetts Behavioral Health Partnership provides behavioral health.

MassHealth policy changes sometimes result in program and funding shifts among MassHealth line items in the state budget. Use caution when comparing these line items from year to year.

Updated, February 2018

Adjusted for inflation (CPI) NOT adjusted
FY19 GAA $5,759,010,341 $5,759,010,341
FY19 Leg $5,759,010,341 $5,759,010,341
FY19 Sen $5,695,714,181 $5,695,714,181
FY19 SWM $5,695,714,181 $5,695,714,181
FY19 Hou $5,759,010,341 $5,759,010,341
FY19 HWM $5,759,010,341 $5,759,010,341
FY19 Gov $5,557,010,341 $5,557,010,341
FY18 $5,689,489,743 $5,553,251,863

Notes

  • Funding for MassHealth and related health reform programs often shifts among line item appropriations and special trust funds from year to year, so it is helpful to look at total funding, rather than at individual line items to get a sense of funding over time. In many years, the Administration has also been allowed to transfer funding among the MassHealth program line items without additional legislative approval. This means that there may be a meaningful difference between the budgeted amount and actual spending for individual line items, and that funding budgeted for one line item is ultimately spent in another.