Three Massachusetts healthcare organizations — Lowell (Mass.) General Hospital, Worcester, Mass.-based Fallon Community Health Plan and the Lowell Community Health Center — applied to form an ACO for Medicaid patients in Lowell, according to the Lowell Sun.
While LGH already has an ACO serving roughly 11,000 Medicare patients, the ACO model for Medicaid patients is a new initiative in Massachusetts. In November 2016, CMS approved a five-year, $52.5 billion Medicaid waiver for Massachusetts. The waiver allows the state to shift the state's Medicaid program, MassHealth, from a fee-for-service to value-based model, including the launch of an ACO pilot program and investments in long-term care services and behavioral health.
Under the three organizations' proposed ACO, Massachusetts patients on MassHealth would receive additional assistance for language, transportation and housing to better coordinate patients' care.
"The goal here is to improve the care of the patients, have better coordination of care for the patients, as well as control unsustainable healthcare costs," Wendy Mitchell, MD, president of LGH's medical staff, told Lowell Sun. "This is very much needed and will make a big difference, I think."