ACO/BeHealthy Partnership – Provider Frequently Asked Questions
Posted on February 13, 2018
Health New England is committed to keeping all of our providers informed of plan changes and other updates related to our lines of business. We would like to inform you of an upcoming change in our Medicaid business.
Earlier this year, we were informed by MassHealth that Health New England has not been awarded a new Managed Care Organization (MCO) contract with Medicaid. Our current MCO contract will end on February 28, 2018.
The good news is Health New England is part of the new Accountable Care Organization (ACO) program in collaboration with the Baystate Health Care Alliance, starting in 2018. Health New England is the MCO for the new MassHealth Accountable Care Partnership Plan called BeHealthy PartnershipSM.
Health New England’s Commercial and Medicare lines of business are not changing and will continue with business as usual.
What this change means to our Medicaid provider network
The BeHealthy Partnership is made up of the Baystate Health Care Alliance and Health New England. Within the Alliance are primary care providers (PCPs) based at five health centers in Springfield, Massachusetts:
- Baystate General Pediatrics at High Street
- Brightwood Health Center
- Caring Health Center
- High Street Health Center Adult Medicine
- Mason Square Neighborhood Health Center
MassHealth/Medicaid members who currently receive care from a PCP at one of these five health centers will automatically become BeHealthy Partnership members, effective March 1, 2018.
Also effective March 1, 2018, we will no longer cover most Medicaid members from Berkshire and Franklin counties.
Please note: Our network of specialists and hospitals is not changing and we will continue to work with our contracted specialists and hospitals throughout Western Massachusetts.
Existing Health New England Medicaid members who receive care from other PCPs will need to select a PCP at one of the five health centers to remain Health New England members. If they want to keep their current PCP, they should enroll in another MassHealth Accountable Care Organization in their local service area.
One of the main goals of the BeHealthy Partnership is to provide Medicaid members with better care coordination and access to key medical and mental health care when and where they need it.
Additional communications and training about this new model of care will be developed and shared with the PCPs who are part of the BeHealthy Partnership.
MassHealth notified Medicaid members in writing in November and December 2017 about the changes to their plans and what actions they need to take, if any. If you get questions from members, please direct them to call the MassHealth Customer Service Center at (800) 841-2900 or TTY (800) 497-4648, Monday – Friday, 8:00 a.m. – 5:00 p.m.
Click here to find a Frequently Asked Questions document with additional information.
Should you have more questions about these changes, please contact Health New England Provider Relations at (800) 842-4464, extension 5000, Monday – Friday, 8:00 a.m. – 5:00 p.m.
If you are a PCP at one of the five health centers listed, please contact your health center’s practice manager with questions.
Sincerely,
Kerry D. LaBounty, LICSW
Director, Government Programs
