Mass. Receives $41.4B for Federal Healthcare Waiver
The state has extended its 1115 demonstration waiver deal to help improve healthcare initiatives.
- Late last week, Massachusetts state government officials announced that the state has reached an agreement with the federal government worth $41.4 billion, which will succeed a three-year $26.75 billion waiver agreement. The money will be used to improve health care in the state.
“Massachusetts has proven itself a national leader in health care reform with our success in extending coverage to nearly all residents of the Commonwealth,” Governor Deval Patrick said in a statement. “This new agreement will help us build on our success while also spearheading innovative cost-containment efforts across the state. We are thankful for the support of the Obama Administration, the Massachusetts Congressional Delegation, and our partners for sharing our commitment to health care reform.”
This is part of the 1115 demonstration waiver deal. This part of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs. The purpose is to give each state additional flexibility to design and improve their programs like expanding eligibility to individuals who are not eligible, provide services not typically covered or use innovative service delivery systems that improve care, increase efficiency and reduce costs.
In general, section 1115 demonstrations are approved for a five-year period and can be renewed for a three year period. Any demonstration must be “budget neutral” to the federal government, which means that during the course of the project, Federal Medicaid expenditures will not be more than Federal spending without the waiver.
According to Boston news outlet WBUR, this represents $640 million less per year when compared to the most recent waiver. During a media conference call, two members of the Patrick administration ran through a list of areas that will be supported by this money. It also does not include the state’s safety net care pool in the fourth and fifth year of the waiver because an agreement has not been met on that yet.
There are several different ways that the money will be spent. This includes:
• $230.2 million per year over a three year period for “transformation initiatives like deploying integrated care systems and moving away from fee-for-services payments.
• $771 million over three years for Medicaid-eligible programs such as homeless supports, chronic disease interventions, substance abuse prevention and rehabilitation and expand access to children’s behavioral health services.
• $308 million per year for three years, for the Cambridge Health Alliance, which is a public hospital that is a unique provider that treats low-income individuals and those without insurance.
Several organizations also announced their support 1115 demonstration including Sisters of Providence Health System, Holyoke Medical Center, the Autism Insurance Resource Center at UMass Medical School, Boston Medical Center, Lawrence General Hospital, Signature Healthcare, Steward Health Care, Cambridge Health Alliance, Health Care For All, and Health Care Financing Committee Co-chairman Sen. James Welch.
“I am very pleased that the renewal of the 1115 waiver has been finalized,” Welch told the news source. “The renewal of the waiver will bring much needed funding to the Commonwealth, which will help to rein in costs as well as secure the continued success of universal health care coverage for Massachusetts residents.”
