UMass Memorial opts out of state Medicaid ACO

The largest provider in central Massachusetts, UMass Memorial Health Care, has decided to opt out of the state’s restructuring of its Medicaid program into an accountable care organization (ACO) model.

The ACO reorganization of MassHealth was approved by CMS last year with a five-year waiver. UMass Memorial had participated in the state’s pilot MassHealth ACO since December, but decided the “financial risks were too great” to move forward.

“After careful and thoughtful consideration, Tufts Health Plans and the Central Massachusetts Accountable Care Organization (CMACO), including: UMass Memorial Health Care, Inc., Harrington Hospital on behalf of its Physician Hospital Organization, Community Health Connections of Fitchburg, Edward M. Kennedy Community Health Center, Family Health Center of Worcester and Heywood Physician Hospital Organization, have decided collectively not to participate in the Medicaid ACO,” UMass Memorial spokesman Tony Berry wrote in an email to the Worcester Telegram.

UMass said it will continue to accept MassHealth beneficiaries, which make up about 27 percent of its admissions. Read the full article at the link below:

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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