Massachusetts Medicaid Waiver Renewal Confirms State Abandoning Fee-For-Service

The recently approved Massachusetts Medicaid waiver proposes changing reimbursements for safety net hospitals from fee-for-service to other payment structures, but does not specify exactly the type of payment model or models that safety net hospitals should move to. The proposal is a delivery system transformation initiative (DSTI) that affects seven hospitals with the highest Medicaid patient volumes and that have previously been considered as Disproportionate Share Hospitals (DSH). The affected hospitals are: Boston Medical Center, Cambridge Health Alliance, Holyoke Medical Center, Lawrence General Hospital, Mercy Medical Center, Signature Healthcare Brockton Hospital, and Steward Carney Hospital. DSH hospitals serve . . .