EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES
COMMONWEALTH OF MASSACHUSETTS
OFFICE OF MEDICAID
ONE ASHBURTON PLACE, BOSTON, MA 02108
MAURA T. HEALEY KATHLEEN E. WALSH
GOVERNOR SECRETARY
KIMBERLEY DRISCOLL MIKE LEVINE
LIEUTENANT GOVERNOR ASSISTANT SECRETARY
FOR MASSHEALTH
October 21, 2024
Chair Aaron Michlewitz
House Committee on Ways and Means
State House, Room 243
Boston, MA 02133
Chair Michael J. Rodrigues
Senate Committee on Ways and Means
State House, Room 212
Boston, MA 02133
Dear Chairs Michlewitz and Rodrigues,
Section 2SSSS of Chapter 29 of the Massachusetts General Laws requires the Executive Office of
Health and Human Services (EOHHS) to submit to the House and Senate Committees on Ways
and Means a detailed accounting of all monies transferred credited or deposited into the
MassHealth Delivery System Reform Incentive Payment (DSRIP) Trust Fund.
Expenditures from the DSRIP Trust Fund include payments for services delivered to MassHealth
beneficiaries by acute hospitals, infrastructure payments for Accountable Care Organizations (ACOs) and
Community Partners (CPs), investments in statewide infrastructure and workforce capacity to support
successful reform implementation, and DSRIP operations and implementation. DSRIP investment funds
are critical in the implementation of the ACO and CP programs and will support care coordination.
In August 2017, 17 health care organizations across the state executed agreements to participate in the
MassHealth ACO program and in December 2017, 26 community organizations executed contracts to
participate in the CP program. MassHealth began paying DSRIP funds to ACOs in September 2017 and
began paying DSRIP funds to CPs in December 2017. Full implementation of the ACO program took place
in March 2018 and full implementation of the CP program took place in July 2018.
Below is the expenditure detail for SFY17-23, and SFY24 Q1-Q3.
DSRIP Trust Fund Payments + Revenue ($M)
SFY17-23 SFY24 Q1 SFY24 Q2 SFY24 Q3
Payments
Disability access to acute hospitals 1,567.1 0.0 0.0 31.5
Payments to ACOs 957.4 19.6 6.1 0.0
Payments to CPs 497.7 0.0 14.7 0.0
Other expenditures 209.1 0.3 6.8 5.4
Subtotal payments 3,231.2 19.9 27.6 36.9
Revenue
Federal revenue 1,929.8 0.0 5.6 29.4
Acute hospital assessment 1,545.0 0.0 0.0 0.0
Subtotal revenue 3,474.8 0.0 5.6 29.4
General Fund Transfer 153.5 0 0 0
ACO & CP returned funds - 0 6.9 5.0
Unexpended Balance 90.1 70.2 55.0 52.5
Trust Fund expenditures are not consistent every quarter due to the timing of payments to providers,
which results in unexpended balances in the Trust at the end of each state fiscal year. Timing of revenue
receipts can vary by quarter which may cause a negative balance in a given quarter.
As part of the DSRIP program, MassHealth prospectively paid ACOs and CPs infrastructure dollars in
accordance with an approved budget for each year. At the end of the final year of DSRIP, ACOs and CPs
reported final expenditures for those infrastructure dollars. Since the infrastructure dollars can only be
used for DSRIP purposes and the program has now ended, MassHealth must recoup all unspent DSRIP
dollars. The ACO & CP returned funds line reflects that recoupment. MassHealth must also return any
federal match associated with the returned funds, which is not yet reflected in the Unexpended Balance.
Thank you for your continuing commitment to the MassHealth program. If you have any
questions about this report, please contact Sarah Nordberg at Sarah.Nordberg@mass.gov.
Sincerely,
Mike Levine
cc: Kathleen E. Walsh