Accountable Care Organization (ACOs)

ACOs are health plans that provide care through groups of doctors, hospitals, and other healthcare providers who come together to give coordinated care to MassHealth members.  In an ACO, a member’s primary care provider (PCP) must be in the network for coverage, and the member must live in the service area. The PCP works with members and their ACO’s heath plan. The member’s PCP also connects them to services and supports. If for some reason a member would like to switch to another health plan, a member can do so during their annual 90-day plan selection period. If a member is in a fixed enrollment period, they are only permitted to change to a new health plan for specific reasons. For more information about ACOs and their service areas, please visit MassHealthChoices.com.

 

Enrollment is open to members who meet the following criteria:

  1. Under 65 with MassHealth as their only insurance

  2. Living in the community (not a nursing home)

  3. In MassHealth Standard, MassHealth CommonHealth, MassHealth CarePlus, or MassHealth Family Assistance

  4. Living in the service area of the plan

There are two types of ACOs members can enroll in:

  1. Accountable Care Partnership Plans
    • In an Accountable Care Partnership Plan, a network of Primary Care Physicians (PCPs) has exclusively partnered with a Managed Care Organization (MCO) to use its health plan to provide integrated and coordinated care to members.  The Accountable Care Partnership Plans currently available are:
      • BeHealthy Partnership

      • Berkshire Fallon Health Collaborative

      • BMC HealthNet Plan Community Alliance

      • BMC HealthNet Plan Signature Alliance

      • BMC HealthNet Plan Mercy Alliance

      • BMC HealthNet Plan Southcoast Alliance

      • Fallon 365 Care

      • My Care Family

      • Tufts Health Together with Atrius Health

      • Tufts Health Together with BIDCO

      • Tufts Health Together with Boston Children's ACO

      • Tufts Health Together with CHA

      • Wellforce Care Plan

  2. Primary Care ACOs

    • A Primary Care ACO is a network of PCPs who contract directly with MassHealth to use MassHealth’s health plan to provide integrated and coordinated care to its members.  Members in a Primary Care ACO receive behavioral health services through the Massachusetts Behavioral Health Partnership (MBHP). The Primary Care ACOs currently available are:

      • Community Care Cooperative (C3)

      • Partners HealthCare Choice

      • Steward Health Choice