MassHealth Managed Care

  • Description
  • Funding History
  • Proposals

MassHealth Managed Care pays for health insurance coverage provided to children and adults through a managed care organization (MCO) with which MassHealth contracts or under the MassHealth Primary Care Clinician (PCC) plan.

Most of the children enrolled in MassHealth receive coverage through a managed care plan provided by a managed care organization or though contracts with primary care clinicians who are responsible for managing a patient's care. The use of managed care has allowed Massachusetts to expand coverage while controlling costs. A smaller number of children are covered under fee-for-service arrangements (see MassHealth Fee-for-Service) but even for those children, their behavioral health services are likely to be covered by a managed care provider.

MassHealth policy changes sometimes result in program and funding shifts among MassHealth line items in the state budget. Use caution when comparing these line items from year to year.

Updated, March 2015

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