MassHealth CMO shares lessons learned from redesigning its delivery system for population health
MassHealth restructured itself as an integrated healthcare delivery system and, in doing so, took its time and made sure that literally everyone was involved.
The engagement process was extremely robust, including stakeholders in the processes and development of our ACO initiative, said Carolyn Langer, MD, chief medical officer and director of the office of clinical affairs at MassHealth.
“In terms of the process, it was pretty formally structured, done over a year and a half, engaging stakeholders across a broad base including patients, providers, government agencies, health plans, the usual suspects, but also advocacy groups that represent consumers and special populations that may require specific services,” added Linda Shaughnessy, director of the quality office at MassHealth. “So we got a broad base across a formal period of time and covered a series of different topics to address delivery system restructuring. Further, there were a number of workgroups that handled specific areas, convening throughout the year.”
Because MassHealth serves a Medicaid population, Langer said it was critical to have a deep understanding of its sub-populations.
“Advocacy groups and consumers included a broad swath of people with significant representation from behavioral health and long-term services and supports,” Langer said. “And we had eight workgroups meeting for several months, and then some of the workgroups continued on. There were also a series of town hall meetings and other opportunities for specific types of experts and stakeholder input.”
Part of the value of this process was identifying linkages and accountability across departments, Shaughnessy said.
“It really allowed us to identify unmet needs or challenges in the delivery system,” she said. “For example, identifying transitions in the coordination of care, and again really focusing not just on the medical side but the long-term services and supports and the integration of behavioral health. It’s a collaborative process and it is iterative, and as it is iterative it builds buy-in along the way. It also provides insights, as we are developing and designing, into the feasibility and readiness among the different stakeholders being able to implement the restructuring.”
Through the design of the ACO model, the organization is not just prioritizing accountability for medical care but also promoting integration between physical health and behavioral health and between physical health and long-term services and supports, Langer said.
“So holding the ACO accountable for developing these partnerships, but also promoting linkages with community-based organizations and community partners that can help to further assess the needs of our members and resources for them in the community,” she said. “As an example of how we use the stakeholder engagement process to do this, we have several workgroups, for example the quality measurement workgroup, where we engaged this multidisciplinary team to help us think about a set of guiding principles and quality measurement domains to ensure we are really promoting quality of care across all of these different areas, like prevention and wellness, chronic disease management, behavioral health, substance abuse, long-term services and supports, care integration, and patient experience.”
Shaughnessy and Langer will discuss their experience at the HIMSS and Healthcare IT News Pop Health Forum, April 3-4, 2017, in the Westin Copley Place in Boston, Massachusetts.
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