Massachusetts Medicaid managed care organizations (MCOs) lost $137 million in 2014, according to MassLive, and a newly released report from the state government helps explain why.
Some of the revenue loss is due to the cost of healthcare, specifically the high prices of specialty prescriptions, the report says. And it's also problematic that MassHealth beneficiaries frequently change plans. This means "the long term benefits of these new treatments may not be felt by either MassHealth or its MCOs," according to the report.
The report recommends that MassHealth implement longer enrollment cycles for its plans as well as increase transparency in plan rate-setting and data sharing among payers, providers and state agencies. Report