The HPC has kicked off a new Accountable Care Organization (ACO) Certification application cycle for two-year certification effective 2022-2023. This year, the standards for certification, now called ACO Learning, Equity, and Patient-Centeredness (LEAP) 2022-23, have been updated to be informed by the National Academy of Medicine’s Learning Health System framework. The LEAP standards emphasize the importance of ACOs’ cultural commitments to learning and performance improvement and embrace of data-driven decision-making approaches to provide better care delivery.  

The ACO Certification program continues to complement local and national care transformation and payment reform efforts, including ongoing alignment with MassHealth’s ACO program, and to encourage value-based care delivery. Since its inception in 2017, the ACO Certification program has served to provide all-payer standards for ACO care delivery and transparent information for the public on ACO structures and operations. As of 2021, the HPC has certified sixteen ACOs that collectively represent 2.9 million attributed commercial, Medicare, and MassHealth patients in the Commonwealth.

The HPC is excited by the opportunities this application cycle offers to continue working with the Commonwealth’s provider community to advance a shared vision of delivery system transformation and shared learning across the health care system. Applications are due by December 31, 2021.

The HPC has published an evaluation of the Targeted Cost Challenge Investments (TCCI) Program, which aimed to reduce health care cost growth in key areas while maintaining or improving quality, access, and staff and patient experience. The TCCI Program, launched in 2016, funded innovative initiatives in five priority areas of high spending: 1) health-related social needs, 2) behavioral health integration, 3) care transitions and post-acute care utilization, 4) serious advancing illness, and 5) site and scope of care. A total of $6.6 million dollars was disbursed to ten awardees, who served 3,836 patients and partnered with more than 60 community organizations over the 18-month implementation period. Awardees observed notable impacts on reducing utilization (e.g., readmissions, ambulance transportation) and total health care costs, addressing health-related social needs (e.g., housing security), increasing access to behavioral health services, and improving patient experience. Through the TCCI Program, awardees developed experience and skills in crafting, testing, and implementing evidence-based models to improve outcomes for the Commonwealth’s most complex populations.

Key takeaways from the TCCI Program Evaluation Report include:

To learn more about this program and other initiatives funded through the HPC’s Health Care Innovation Investment Program, please visit the HPC's website. 

The 2021 Health Care Cost Trends Report (available here; accompanying chartpack here; executive summary here; and interactive dashboard here) identifies factors contributing to the state’s performance relative to the health care cost growth benchmark, highlights opportunities to increase quality and efficiency, and recommends policy actions be taken to address the continued high cost of health care in the Commonwealth. 

Despite several years of notable progress, spending has grown in excess of the benchmark for the past two years. The Center for Health Information and Analysis's (CHIA) Annual Report, released earlier this year, showed that the state exceeded the benchmark from 2018 to 2019 with an increase of 4.3%. Unless urgently addressed, these concerning trends will result in a health care system that is increasingly unaffordable for Massachusetts residents and businesses and will deepen long-standing health inequities.

The HPC recommends immediate action to strengthen and enhance the state’s strategy for addressing the intersecting challenges of cost containment, affordability, and health equity to improve outcomes and lower costs for all. The complete set of policy recommendations can be found here.

In addition to implementing the above items, the HPC recommends that the Commonwealth sustain the successful innovations made during the COVID-19 pandemic, such as expanded access to telehealth, workforce flexibilities, and new care models.

Building on the Health Care Cost Trends Report, the HPC’s 2021 Health Care Cost Trends Hearing will take place on November 17, 2021 at 12:00 PM. The annual health care cost trends hearing is a public event at which elected officials, policymakers, researchers, and health care market participants convene to address challenges and discuss opportunities for improving care and reducing costs in the Commonwealth. The virtual hearing will feature live testimony from top health care executives, industry leaders, and government officials. Information about the 2021 hearing can be found on the HPC website and a registration link can be found here.