Dive Brief:
- Massachusetts Gov. Deval Patrick and the Obama administration have reached a 5-year, $41 billion deal on the state's next 1115 Medicaid demonstration waiver. The last waiver, a 3-year deal worth $26.75 billion, expired over the summer.
- Although the average annual funding provided under the new waiver appears to be lower than that provided under the last waiver on first glance, Massachusetts officials noted it only seems that way since the last two years of funding aren't included yet in the current deal, because there is a plan and process in place to redesign certain aspects of the waiver in those years.
- Provisions of the deal include $771 million for Medicaid-eligible programs over the next three years; $230.2 million over the next three years for "transformation initiatives" to shift towards coordinated care and away from fee-for-service models; and public children's pilot programs to reform mental health care delivery and treatment for special needs children.
Dive Insight:
The Patrick administration was quick to praise the length and size of the deal, arguing that it will provide certainty and clear vision for the state's public health programs over the next half-decade. “This new agreement will help us build on our success while also spearheading innovative cost-containment efforts across the state," said Gov. Patrick in a statement.
State officials did concede that the level of funding provided under the demonstration waiver deal was lower than they had originally requested. However, the federal government largely granted the states' requests in general. Cambridge Health Alliance and Boston Medical Center fared particularly well under the deal, with the former winning a 10% funding increase from the previous waiver.
The deal will also partially fund the costs of putting 300,000 poor residents, temporarily, into Medicaid coverage due to problems with Massachusetts' ACA exchange.
