The A An MCO A Partnership Plan PCC Primary Plan Care ACO (regardless of whether or not they are attributed to an ACO) Be in MassHealth’s Contract with Contract with each Partnership Hospital hospital network each MCO Plan whose enrollees I want to (via the whose see (negotiated rate) MassHealth enrollees I hospital RFA) want to see (negotiated rate) Professional (e.g., Be a specialist) provider (via MH professional reg/fee schedule) Behavioral Health Be an in-network Contract with Contract with each Partnership (BH) Provider provider for each MCO (or Plan (or that Plan’s BH Vendor if MassHealth’s BH that MCO’s BH they have one) whose enrollees Vendor (via Vendor if they I want to see (negotiated rate) contract with the have one) BH Vendor) whose enrollees I want to see (negotiated rate)
The PCC Plan A Primary Care ACO An MCO A Partnership Plan (regardless of whether or not they are attributed to an ACO) Hospital Be in MassHealth’s hospital network (via the MassHealth hospital RFA) Contract with each MCO whose enrollees I want to see (negotiated rate) Contract with each Partnership Plan whose enrollees I want to see (negotiated rate) Professional (e.g., specialist) Be a provider (via MH professional reg/fee schedule) Behavioral Health (BH) Provider Be an in-network provider for MassHealth’s BH Vendor (via contract with the BH Vendor) Contract with each MCO (or that MCO’s BH Vendor if they have one) whose enrollees I want to see (negotiated rate) Contract with each Partnership Plan (or that Plan’s BH Vendor if they have one) whose enrollees I want to see (negotiated rate)
restructuring-open-public-meeting-march-2017.docx