The bill outlines the operations and reporting requirements for the One Care program, which aims to enhance care for adults aged 21-64 who are dual eligible for both Medicare and Medicaid in Massachusetts. The Executive Office of Health and Human Services (EOHHS) is mandated to 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 at skilled nursing facilities. As of January 2026, there are 38,327 individuals enrolled in One Care plans, which are designed to provide comprehensive and coordinated services through contracted managed care entities.
Additionally, the bill details the financial aspects of the One Care program, including the average monthly capitation payment made by MassHealth to the plans and the performance-based quality measures that affect capitation payments. The One Care program transitioned to a Dual-Eligible Special Needs Plan (D-SNP) in January 2026, with capitation rates calculated based on actuarial estimates of costs for serving members. The bill also provides a contact for further information regarding the One Care program, specifically through the email address Sarah.Nordberg@mass.gov.