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
December 19, 2024
Chair, Michael J. Rodrigues Chair, Aaron Michlewitz
Senate Committee on Ways and Means House Committee on Ways and Means
State House, Room 212 State House, Room 243
Boston, MA 02133 Boston, MA 02133
Dear Chairs Rodrigues and Michlewitz,
Chapter 28 of the Acts of 2023, Line Item 1595-1070, requires the Executive Office of Health
and Human Services (EOHHS) to submit to the Senate and House Committee on Ways and
Means a report on payments, investment, and assessments of the Safety Net Provider Trust Fund.
In accordance with that appropriation, funds have been expended from that line item since the
beginning of state fiscal year (SFY) 2023 in accordance with the Safety Net Provider eligibility
criteria and payment methodology approved in MassHealth’s section 1115 demonstration waiver
(the “1115 Demonstration”) for SFY 2020, SFY 2021, SFY 2022, the final calendar quarter of
calendar year (CY) 2022, and CY 2023.
This report provides data only for SFY 2020 through CY 2023. EOHHS has already completed
Safety Net Provider Trust Fund reporting for years prior to SFY 2020. Additionally, there were
no funds paid out to providers from the Safety Net Provider Trust Fund in the third quarter of CY
2022. Therefore, there is no data to provide for such calendar quarter in this report.
On September 28, 2022, CMS approved a five-year extension of the MassHealth Section 1115
Demonstration. MassHealth’s previous 1115 Demonstration extension (July 1, 2017 through
September 30, 2022) restructured the delivery system toward integrated, value-based and
accountable care. MassHealth’s new 1115 Demonstration extension (October 1, 2022 through
December 31, 2027) builds on these reforms by continuing to support integrated, outcomes-
based care for MassHealth members and bringing a new focus on advancing health equity by
closing disparities in quality and access. Goals for the new 1115 Demonstration extension
include: continuing the path of restructuring and reaffirming accountable, value-based care,
making reforms and investments in primary care, behavior health, and pediatric care, advancing
health equity, sustaining the safety net, and maintaining near universal coverage. The new 1115
Demonstration extension also authorized funding to continue the Commonwealth’s longstanding
support for safety net hospitals. The waiver authorized MassHealth to provide Safety Net
Provider Payments to the safety net hospitals serving the highest proportion of MassHealth and
uninsured patients in the Commonwealth.
I am grateful for your continued support of the MassHealth program and the safety net hospitals
that serve a large number of our members. Please feel free to contact Sarah Nordberg at
Sarah.Nordberg@mass.gov should you have any questions about this report.
Sincerely,
Mike Levine
cc: Kathleen E. Walsh
Safety Net Provider Trust Fund Legislative Report
I. Payments Made to Each Provider
Tables 1, 2, 3, 4, and 5 below, respectively identify, for SFY 2020, SFY 2021, and SFY 2022,
the final calendar quarter of CY 2022, and CY 2023, (1) each of the providers who received
payment from the Safety Net Provider Trust Fund and (2) the total payment made to each such
provider from the Safety Net Provider Trust Fund. In accordance with the Commonwealth’s
Delivery System Reform Incentive Payment (DSRIP) Protocol (Appendix M to MassHealth’s
1115 Demonstration extension, effective July 1, 2017 through September 30, 2022), and Safety
Net Hospital Provider Payment Eligibility and Allocation Protocol (Appendix N to MassHealth’s
1115 Demonstration extension, effective October 1, 2022 through December 31, 2027), EOHHS
withheld a percentage of each payment from the Safety Net Provider Trust Fund. Participating
safety net providers earned the withheld funds by meeting certain metrics set forth in the DSRIP
Protocol or the Safety Net Hospital Provider Payment Eligibility and Allocation Protocol, as
applicable. The figures listed in the “Base Payment” columns in Tables 1, 2, 3, 4, and 5 are each
provider’s SFY 2020, SFY 2021, SFY 2022, final calendar quarter of CY 2022, and CY 2023
allocation after subtracting each provider’s withheld funds. The figures listed under the “At-Risk
Funding Achieved” column are the withheld funds each provider earned after demonstrating
achievement on the metrics set forth in the DSRIP Protocol or the Safety Net Hospital Provider
Payment Eligibility and Allocation Protocol, as applicable. In accordance with authorization
from the Secretary of Administration and Finance, EOHHS funded portions of each of the SFY
2020 and SFY 2021 Base Payments from appropriations to line item 4000-0700. Please note that
EOHHS has not yet determined the full amount of each provider’s SFY 2021, SFY 2022, final
1
At-risk funding achieved as of March 2024. Payment levels will be updated, as additional performance data
becomes available, in next year’s report.
2
Final calendar quarter of CY 2022, the start of the most recent 1115 Demonstration extension, was defined by
CMS as a separate demonstration year.
3
Starting with CY 2023, the 1115 Demonstration transitioned from a SFY cadence to a CY cadence.
calendar quarter of CY 2022, and CY 2023 At-Risk Funding Achieved, as a portion of these
figures is tied to performance measure results that are not yet available. Final performance data
for SFY 2021, SFY 2022, and the last calendar quarter of CY 2022 is expected to be available by
the end of CY 2024. Final performance data for CY 2023 is expected to be available by the end
of CY 2025. The safety net providers will earn all, some, or none of the remaining withheld
funds based on their performance against those metrics.
Table 1. SFY 2020 Safety Net Provider Payments
Provider Base Payment At-Risk Funding
Achieved1
Boston Medical Center $98,327,500.00 $7,885,121.40
Holyoke Medical Center $6,003,250.00 $481,415.22
Lawrence General Hospital $11,562,500.00 $913,503.76
Mercy Medical Center $11,285,000.00 $850,299.13
Signature Healthcare $1,007,235.00
$12,487,500.00
Brockton Hospital
Steward Carney Hospital $4,736,000.00 $360,906.24
Baystate Medical Center $5,189,250.00 $408,847.82
North Shore Medical Center $3,117,250.00 $240,855.82
Southcoast Hospital Group $3,764,750.00 $274,989.55
Tufts Medical Center $3,145,000.00 $235,854.60
Morton Hospital $462,500.00 $35,244.75
Franklin Medical Center $434,750.00 $34,252.85
Berkshire Medical Center $1,507,750.00 $115,288.28
Good Samaritan Hospital $878,750.00 $66,965.04
Table 2. SFY 2021 Safety Net Provider Payments
Provider Base Payment At-Risk Funding
Achieved1
Boston Medical Center $93,012,500.00 $10,649,080.85
Holyoke Medical Center $5,678,750.00 $650,164.96
Lawrence General Hospital $10,675,000.00 $1,498,500.38
Mercy Medical Center $10,605,000.00 $1,199,331.57
Signature Healthcare $1,353,863.53
Brockton Hospital $11,637,500.00
Steward Carney Hospital $4,480,000.00 $499,871.39
Baystate Medical Center $4,908,750.00 $516,922.79
North Shore Medical Center $2,948,750.00 $328,764.50
Southcoast Hospital Group $3,561,250.00 $416,469.87
1
At-risk funding achieved as of March 2024. Payment levels will be updated, as additional performance data
becomes available, in next year’s report.
2
Final calendar quarter of CY 2022, the start of the most recent 1115 Demonstration extension, was defined by
CMS as a separate demonstration year.
3
Starting with CY 2023, the 1115 Demonstration transitioned from a SFY cadence to a CY cadence.
 Tufts Medical Center $2,975,000.00 $320,146.55
Morton Hospital $437,500.00 $48,815.57
Franklin Medical Center $411,250.00 $43,307.26
Berkshire Medical Center $1,426,250.00 $159,363.59
Good Samaritan Hospital $831,250.00 $92,749.58
Table 3. SFY 2022 Safety Net Provider Payments
Provider Base Payment At-Risk Funding
Achieved1
Boston Medical Center $86,798,250.00 $5,323,889.02
Holyoke Medical Center $5,354,250.00 $328,410.22
Lawrence General Hospital $9,462,750.00 $518,049.44
Mercy Medical Center $9,933,000.00 $601,506.36
Signature Healthcare $692,484.99
Brockton Hospital $10,947,750.00
Steward Carney Hospital $4,224,000.00 $248,656.03
Baystate Medical Center $4,628,250.00 $237,954.32
North Shore Medical Center $2,780,250.00 $161,901.54
Southcoast Hospital Group $3,357,750.00 $217,334.95
Tufts Medical Center $2,805,000.00 $159,081.75
Morton Hospital $412,500.00 $24,282.82
Franklin Medical Center $387,750.00 $19,935.57
Berkshire Medical Center $1,344,750.00 $79,477.29
Good Samaritan Hospital $783,750.00 $46,137.35
Table 4. Final Calendar Quarter of CY 2022 Safety Net Provider Payments2
Provider Base Payment
Boston Medical Center $34,865,000.00
Holyoke Medical Center $2,151,000.00
Lawrence General Hospital $3,801,000.00
Mercy Medical Center $3,990,000.00
Signature Healthcare Brockton $4,398,000.00
Hospital
Steward Carney Hospital $1,697,000.00
Baystate Medical Center $4,434,000.00
North Shore Medical Center $2,303,000.00
Southcoast Hospital Group $3,631,000.00
Tufts Medical Center $4,083,000.00
Morton Hospital $394,000.00
1
At-risk funding achieved as of March 2024. Payment levels will be updated, as additional performance data
becomes available, in next year’s report.
2
Final calendar quarter of CY 2022, the start of the most recent 1115 Demonstration extension, was defined by
CMS as a separate demonstration year.
3
Starting with CY 2023, the 1115 Demonstration transitioned from a SFY cadence to a CY cadence.
 Franklin Medical Center $389,000.00
Berkshire Medical Center $1,492,000.00
Good Samaritan Hospital $876,000.00
Baystate Noble Hospital $211,000.00
Baystate Wing Hospital $312,000.00
Heywood Memorial Hospital $499,000.00
Martha's Vineyard Hospital $291,000.00
Steward Holy Family Hospital $989,000.00
Lowell General Hospital $1,887,000.00
Shriners Hospital For Children $219,000.00
Boston
Shriners Hospital For Children $135,000.00
Springfield
MetroWest Medical Center $1,606,000.00
Table 5. CY 2023 Safety Net Provider Payments3
Provider Base Payment
Boston Medical Center $111,566,400.00
Holyoke Medical Center $6,882,400.00
Lawrence General Hospital $12,163,200.00
Mercy Medical Center $12,767,200.00
Signature Healthcare Brockton $14,072,000.00
Hospital
Steward Carney Hospital $5,429,600.00
Baystate Medical Center $14,188,000.00
North Shore Medical Center $7,370,400.00
Southcoast Hospital Group $11,619,200.00
Tufts Medical Center $13,066,400.00
Morton Hospital $1,260,000.00
Franklin Medical Center $1,243,200.00
Berkshire Medical Center $4,775,200.00
Good Samaritan Hospital $2,804,000.00
Baystate Noble Hospital $676,000.00
Baystate Wing Hospital $997,600.00
Heywood Memorial Hospital $1,596,000.00
Martha's Vineyard Hospital $932,000.00
Steward Holy Family Hospital $3,163,200.00
Lowell General Hospital $6,039,200.00
Shriners Hospital For Children $700,000.00
Boston
1
At-risk funding achieved as of March 2024. Payment levels will be updated, as additional performance data
becomes available, in next year’s report.
2
Final calendar quarter of CY 2022, the start of the most recent 1115 Demonstration extension, was defined by
CMS as a separate demonstration year.
3
Starting with CY 2023, the 1115 Demonstration transitioned from a SFY cadence to a CY cadence.
 Shriners Hospital For Children $45,800.00
Springfield
MetroWest Medical Center $5,137,600.00
II. Provider Investments and Assessments of Recipient Provider
As stated in MassHealth’s 1115 Demonstration, the Commonwealth may make Safety Net
Provider Payments to eligible hospitals, in recognition of safety net providers in the
Commonwealth that serve a large proportion of Medicaid and uninsured individuals and have a
demonstrated need for support to address “uncompensated care costs,” as that term is defined at
42 CFR 447.299. These payments are intended to provide ongoing and necessary operational
support; as such, they are not specifically for the purposes of delivery system reform, are not
time limited, and recipients are not required to report to EOHHS on the specific uses of the
funds.
Providers receiving Safety Net Provider Payments in accordance with MassHealth’s 1115
Demonstration were required to meet certain accountability requirements, aligned with the
overall goals identified in the 1115 Demonstration. In each year of the 1115 Demonstration,
hospitals that receive Safety Net Provider Payments were required to participate in one of
MassHealth’s Accountable Care Organization (“ACO”) models. In turn, all participants in
MassHealth’s ACO program were required to make investments in and adjustments to their
delivery systems, or meet metrics in health quality and total cost of care, as applicable, in order
to meaningfully participate in the program.
A portion of each provider’s Safety Net Provider Payment was at risk during each year of the
1115 Demonstration, subject to that provider’s performance against a series of accountability and
performance measures specified in the Commonwealth’s DSRIP Protocol for the 1115
Demonstration, effective July 1, 2017 through September 30, 2022. Starting with October 1,
2022, under the new 1115 Demonstration extension, at risk funding is subject to quality and total
cost of care performance, as specified in the Safety Net Hospital Provider Payment Eligibility
and Allocation Protocol. For each of SFYs 2020, 2021, and 2022, EOHHS has made payments
(see Tables 1, 2, and 3 At-Risk Funding Achieved) based on performance data available as of
March 2024. Final performance data for SFY 2021, SFY 2022, and the final calendar quarter of
CY 2022 is expected to be available by the end of CY 2024. Final performance data for CY
2023 is expected to be available by the end of CY 2025. As performance data becomes available
for SFY 2021, SFY 2022, the final calendar quarter of CY 2022, and CY 2023 payments will be
made according to each hospital’s achievement.
1
At-risk funding achieved as of March 2024. Payment levels will be updated, as additional performance data
becomes available, in next year’s report.
2
Final calendar quarter of CY 2022, the start of the most recent 1115 Demonstration extension, was defined by
CMS as a separate demonstration year.
3
Starting with CY 2023, the 1115 Demonstration transitioned from a SFY cadence to a CY cadence.