Massachusetts Medicaid Seeks 1115 Waiver Extension Adding Hospital Incentives & Global Budgeting

Massachusetts is seeking a five-year extension of its Medicaid Section 1115 Demonstration that would continue the state's accountable care organization (ACO) model while introducing new hospital incentives and an optional global budget payment model. The proposed extension would run from January 1, 2028, through December 31, 2032, and would also continue existing primary care, behavioral health, substance use disorder (SUD), nutrition, tenancy, and reentry initiatives.

MassHealth released the 2028–2032 Section 1115 Demonstration extension request for public comment on September 14, 2026. Comments will be accepted through October 19, 2026, and the state plans to submit the request . . .