The bill outlines the ongoing efforts of the Executive Office of Health and Human Services (EOHHS) in Massachusetts to enhance care for adults aged 21-64 who are dual eligible for both Medicare and Medicaid through the One Care program. This initiative aims to provide integrated, person-centered care by utilizing contracted managed care entities that deliver comprehensive services. The program has shown promising results, achieving high quality and member experience ratings. The Fiscal Year 2025 budget mandates that EOHHS report to the House and Senate Committees on Ways and Means regarding the number of members served, average expenditures per member, and the number of clients receiving care in skilled nursing facilities.

As of December 2024, there are 41,599 individuals enrolled in One Care plans, which include various care categories. The program has contracts with three One Care plans, which cover a wide range of services, including Medicare and MassHealth benefits. The average monthly payment per enrollee for calendar year 2024 is reported at $1,997.67, reflecting the concentration of higher-cost members. Additionally, a performance-based quality measure system is in place, withholding approximately $23.8 million from plan payments, which will be distributed based on the achievement of specific quality benchmarks. The bill also includes a new contact email for further inquiries regarding the One Care program: Sarah.Nordberg@mass.gov.