In March 2018, Massachusetts implemented a redesigned managed care financing and delivery system. The redesign is called Payment and Care Delivery Innovation (PCDI). The PCDI redesign retains the state’s primary care case management (PCCM) and traditional managed care organizations while adding accountable care organizations (ACOs). Financing and delivery for the models varies by type. The Primary Care Accountable Care Organization (PC-ACO) model are groups of primary care providers work directly with the state’s network of provider organizations to deliver primary care and to coordinate the full range of services. The Managed Care Organization (MCO) model are two traditional health plans provide services on a capitated basis. The Accountable Care Partnership Plan (ACPP) model are a group of primary care providers that partner with an insurer to coordinate and integrate care using the insurer’s network.
This Massachusetts Medicaid Contract is for Fallon 365 Care, signed January 1, 2019.
For more information on Massachusetts’ Medicaid managed care programs, and to view other contracts, visit Massachusetts Medicaid Managed Care Contracts.