A Massachusetts Medicaid planning lawyer provides assistance to people who need Medicaid to pay for their nursing home care or to pay for other costly healthcare. Medicaid provides coverage in a lot of situations where no other insurance companies provide coverage. It is important to understand exactly what Medicaid does, how it works, and how to become eligible for Medicaid coverage. The Law Offices of James A. Miller, P.C. can help you to find out about things like Medicaid eligibility rules and covered services, so you should talk with an experienced attorney at our firm as soon as possible.
It is important for those who need Medicaid to keep track of changes to the program. Just recently, Boston Globe reported on big changes to Medicaid in Massachusetts. Six healthcare networks are trying out new MassHealth models, and the outcomes of the testing could make a big impact on care for patients throughout Massachusetts who are relying on Medicaid to cover health services.
New MassHealth System Being Tested by Massachusetts Networks
According to Boston Globe, Massachusetts has made the biggest changes to its Medicaid program in more than 20 years. The changes to Medicaid center around altering the current fee-for-service models and switching instead to an accountable care model. An accountable care model focuses not just on what services are provided to Medicaid patients but instead on the outcomes that patients attain when treatment is provided to them.
In Massachusetts, the Medicaid program is called MassHealth. It provides coverage for healthcare for around 1.9 million families in Massachusetts, including people with no incomes or low incomes. Unfortunately, Medicaid is a very costly program and the new shift to an accountable care model are aimed at helping to control expenditures.
Under the new system, providers who offer services to patients covered by MassHealth will receive set budgets for care, instead of billing the state for every service offered to Medicaid patients. If the care providers come in under their budgets, they will be entitled to keep some of the money that they saved. If they come in over the budget, the providers are going to be responsible for some of the losses from the cost overruns.
There are six providers who will be trying out the new system first. Altogether, around 160,000 Medicaid patients will be in the pilot program in which the new accountable care model is tested. The six providers are setting up accountable care organizations (ACOs) that consist of groups of healthcare providers and facilities, such as doctors, hospitals, and other facilities. The models are focused on helping providers to manage and prevent illnesses so their patients stay healthier.
The ACOs are planning on working closely with other groups that can help Medicaid recipients make healthy decisions aimed at reducing costly and expensive illnesses. This includes working with community-based healthcare organizations as well as with groups offering long-term support and groups that help to meet health-related social needs. A collaborative effort is also being made with groups that support behavioral health.
The initial pilot program is expected to last around one year. The 160,000 members whose care providers are a part of the pilot program should not notice a change in their doctors or in availability of benefits. Any MassHealth patient who opts out will be allowed to leave the pilot program at any time.
While the pilot program is starting with just six networks, many more will eventually make a switch. By December of 2017, full implementation of the new accountable care system is expected to occur and provider networks throughout the state of Massachusetts will be operating under the new system. Hopefully, this will help to improve the quality of care and the outcomes for Medicaid patients so these patients can maintain optimum health.
Getting Help from A Massachusetts Medicaid Planning Lawyer
A Massachusetts Medicaid planning lawyer can provide invaluable assistance with Medicaid planning and with making certain that you get care you need, including nursing home care if you get older and can no longer live alone.
The Law Offices of James A. Miller, P.C. has helped many families in Worcester and surrounding areas to get their care costs covered and to make certain that Medicaid provides for them when needed. Download a free estate planning worksheet to find out how Medicaid planning fits within the estate planning process. You can also give us a call at 866-370-3888 or contact us online to get personalized advice. Call today to talk with an attorney to get started on making your plans to get care.
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