Press Release: 2/25/2026

New UMass Chan Evaluation: Innovation at MassHealth Led to Improved Health Outcomes and Lower Costs

 



Evaluation finds half a billion dollars in savings and improved physical and behavioral health outcomes for MassHealth members 



FOR IMMEDIATE RELEASE:



2/24/2026



MEDIA CONTACT



Stacey Nee, Director of Communications, MassHealth



 Online



Email Stacey Nee, Director of Communications, MassHealth at Stacey.Nee2@mass.gov



BOSTON — MassHealth’s innovative health care system reforms are paying off in dollars saved and better health outcomes, according to a recently published study conducted by researchers at UMass Chan Medical School. Findings show that MassHealth’s 2017-2022 Section 1115 Demonstration Waiver (“Waiver”) saved Massachusetts more than half a billion dollars over five years, maintained near-universal health coverage and the lowest uninsurance rate among comparison states, improved health outcomes for MassHealth members in terms of both physical and behavioral health, and lowered hospitalization rates. 



With approval from the Centers for Medicare & Medicaid Services (CMS), waivers allow states flexibility to design and improve their Medicaid and CHIP programs through experimental, pilot, or demonstration projects. Since 1997, the MassHealth Demonstration Waiver has been a critical tool in enabling Massachusetts to achieve near-universal health coverage, reform the way that health care is delivered for MassHealth members, expand critical behavioral health services, and support the state’s safety net health care facilities.



“Massachusetts is home to the best health care system in the world, and MassHealth plays a critical role in that,” said Governor Maura Healey. “This report affirms that the reforms undertaken by MassHealth these past few years have led to lower costs and better coverage. I congratulate the team at MassHealth on this significant accomplishment, and we will keep working together to build on this progress.” 

 

“We know that we must find innovative ways to lower health care costs here in Massachusetts and across the country,” said Lt. Governor Kim Driscoll. “This exciting study highlights that there are ways to do so while also improving health outcomes.” 



UMass Chan’s evaluation of MassHealth’s 2017-2022 waiver examined the impact of a variety of health care system reforms, including MassHealth’s historic transition from paying health care providers for individual member services to paying Accountable Care Organizations (ACOs) a lump sum per member per month, with incentives to improve health outcomes. An ACO is a group of doctors, hospitals, and other health care providers that come together to provide coordinated, high-quality care to a group of patients. MassHealth is a national leader in health care reform, and the ACO model is a key aspect of the agency’s strategy to improve care and reduce costs. 



“This documented success of our MassHealth program is even more important at this moment when federal priorities are shifting for Medicaid,” said Secretary of Health and Human Services Kiame Mahaniah, MD, MBA. “In Massachusetts, we’ve proven that with innovative approaches, you can lower health care spending while helping people live healthier lives. It’s not just the right thing to do for patient care, it’s finding efficient and responsible ways to spend Medicaid funding to best support people in Massachusetts.” 



“Improving health outcomes and reducing costs is central to our mission at MassHealth,” said Undersecretary for MassHealth Mike Levine. “I am encouraged by this study and look forward to finding more ways to keep our members healthy and keep health care spending in check.”



Study co-leads and UMass Chan faculty Matthew Alcusky, PhD, PharmD, associate professor of population & quantitative health sciences, and Ying “Elaine” Wang, PhD, associate professor of population & quantitative health sciences, said, “We spoke with people from across the health care system, and all shared a commitment to making these reforms work. From the beginning, MassHealth designed the changes carefully and adjusted based on feedback and quickly progressed toward its transformation goals. Efforts to expand coverage, such as updating eligibility rules and paying for new substance use disorder services, yielded meaningful results.”



“This study is a powerful illustration of how evidence-based research shapes health policy,” saidMichael F. Collins, Chancellor of UMass Chan. “Our faculty is deeply committed to partnering with state leaders to improve quality of care and support the health of those who need it most.”



Key findings of the report include: 



Cost Savings




  • The ACO model, including key programs to address health-related social needs (e.g., targeted nutrition programs and housing supports), demonstrated a high return on investment.

  • MassHealth’s ACO program saved $512 million over the 5-year demonstration period, with a projected 10-year savings of $962 million. 

  • For every dollar invested in the ACO program, there was an associated $1.35 in total cost of care savings. 

  • Per-member costs for MassHealth members enrolled in an ACO were significantly lower than they would have been without the Demonstration.

  • Health care reforms shifted utilization from high-cost settings to lower-cost outpatient settings while maintaining high levels of member satisfaction in the ACO program.

  • Nutrition supports for MassHealth members reduced total cost of care for participants who received at least 90 days of support. 



Health Outcomes




  • Among MassHealth members in ACOs, there were improvements in diabetes and high blood pressure management, appropriate use of emergency departments, and timely follow-up after an emergency department visits. 

  • MassHealth members with substance use disorder (SUD) saw improvements in health outcomes, including:



o    decreases in the rates of overdoses and overdose fatalities, 



o    improvements in SUD treatment initiation and engagement, 



o    increase in the utilization of new SUD services, 



o    improvements in SUD quality of care and outcomes, and 



o    increases in the number of providers treating SUD. 



Near-Universal Health Insurance Coverage




  • The Demonstration was successful at keeping Massachusetts’ uninsurance rate the lowest in the nation – less than 3 percent.



Hospitalization and Emergency Department Rates




  • Hospitalization rates were 23% lower and Emergency Department visit rates were 13% lower among those receiving nutrition support services, as compared to eligible non-participants.

  • Hospitalization rates were 18% lower and Emergency Department visit rates were 17% lower among those receiving tenancy support services, as compared to eligible non-participants.



For more details and the complete results of the evaluation of MassHealth’s 2017-2022 Demonstration Waiver, visit: Mass.gov/Historic1115Demonstration



In 2022, CMS approved Massachusetts to extend its Demonstration Waiver through 2027. Learn more at: Mass.gov/1115DemonstrationWaiver