MA MEDICAID MARKET
Massachusetts
monitoring
No current verified market signal.
Last verified: unavailable
Last verified: unavailable · no state-specific item
No current verified signal
Precapture is monitoring this market. No state-specific public intelligence item is currently published.
Plans in this market
Parent, plan, and program come from the plan graph. Enrollment and share use the latest CMS reported count. Operations counts are CMS MCPAR. A dollar amount is not on this page.
Plans in this market 133
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| Point32Health | Merrimack Valley ACO in partnership with AllWays Health Partners (My Care Family) | not reported | 40,416 (2022) | 6.1% calculated | not reported |
| Point32Health | Merrimack Valley ACO in partnership with AllWays Health Partners | not reported | 35,125 (2020) | 6.0% calculated | not reported |
| Point32Health | Merrimack Valley ACO in partnership with AllWays Health Partners | not reported | 33,160 (2019) | 6.0% calculated | not reported |
| Point32Health | Merrimack Valley ACO in partnership with AllWays Health Partners (My Care Family) | not reported | 40,416 (2021) | 6.1% calculated | not reported |
| not reported | Boston Medical Center Health Plan | not reported | 170,750 (2017) | 21.3% calculated | not reported |
show all 133
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| not reported | Health New England | not reported | 62,494 (2017) | 7.8% calculated | not reported |
| not reported | Massachusetts Behavioral Health Partnership | not reported | 624,711 (2022) | 100.0% calculated | not reported |
| Boston Medical Center Health Plan | BMC HealthNet Plan | not reported | 43,532 (2021) | 39.3% calculated | not reported |
| Boston Medical Center Health Plan | BMC HealthNet Plan | not reported | 43,532 (2022) | 39.3% calculated | not reported |
| Boston Medical Center Health Plan | Boston Accountable Care Organization in partnership with BMC HealthNet Plan | not reported | 141,104 (2022) | 21.4% calculated | not reported |
| Boston Medical Center Health Plan | East Boston Neighborhood Health WellSense Alliance | not reported | 26,427 (2024) | 3.4% calculated | 1 sanctions, 57 appeals resolved |
| Boston Medical Center Health Plan | Mercy Medical Center in partnership with BMC HealthNet Plan | not reported | 32,117 (2022) | 4.9% calculated | not reported |
| Boston Medical Center Health Plan | Signature Healthcare in partnership with BMC HealthNet Plan | not reported | 22,432 (2022) | 3.4% calculated | not reported |
| Boston Medical Center Health Plan | Southcoast Health in partnership with BMC HealthNet Plan | not reported | 20,043 (2022) | 3.0% calculated | not reported |
| Boston Medical Center Health Plan | WellSense Beth Israel Lahey Health (BILH) Performance Network ACO | not reported | 61,075 (2024) | 7.9% calculated | 1 sanctions, 756 appeals resolved |
| Boston Medical Center Health Plan | WellSense Boston Children's ACO | not reported | 106,816 (2024) | 13.8% calculated | 1 sanctions, 359 appeals resolved |
| Boston Medical Center Health Plan | WellSense Care Alliance | not reported | 50,270 (2024) | 6.5% calculated | 1 sanctions, 343 appeals resolved |
| Boston Medical Center Health Plan | WellSense Community Alliance | not reported | 126,901 (2024) | 16.4% calculated | 1 sanctions, 747 appeals resolved |
| Boston Medical Center Health Plan | WellSense Essential MCO | not reported | 20,712 (2024) | 41.1% calculated | 1 sanctions, 188 appeals resolved |
| Boston Medical Center Health Plan | WellSense Mercy Alliance | not reported | 27,212 (2024) | 3.5% calculated | 129 appeals resolved |
| Boston Medical Center Health Plan | WellSense Signature Alliance | not reported | 22,464 (2024) | 2.9% calculated | 2 sanctions, 98 appeals resolved |
| Boston Medical Center Health Plan | WellSense Southcoast Alliance | not reported | 16,909 (2024) | 2.2% calculated | 1 sanctions, 218 appeals resolved |
| Boston Medical Center Health Plan | Boston Accountable Care Organization in partnership with BMC HealthNet Plan | not reported | 117,013 (2019) | 21.2% calculated | not reported |
| Boston Medical Center Health Plan | Boston Accountable Care Organization in partnership with BMC HealthNet Plan | not reported | 125,747 (2020) | 21.4% calculated | not reported |
| Boston Medical Center Health Plan | Boston Medical Center HealthNet Plan | not reported | 41,930 (2020) | 40.4% calculated | not reported |
| Boston Medical Center Health Plan | Boston Medical Center Healthnet Plan | not reported | 1,521 (2020) | 2.3% calculated | not reported |
| Boston Medical Center Health Plan | Mercy Medical Center in partnership with BMC HealthNet Plan | not reported | 29,502 (2020) | 5.0% calculated | not reported |
| Boston Medical Center Health Plan | Signature Healthcare in partnership with BMC HealthNet Plan | not reported | 19,591 (2020) | 3.3% calculated | not reported |
| Boston Medical Center Health Plan | Southcoast Health in partnership with BMC HealthNet Plan | not reported | 17,736 (2020) | 3.0% calculated | not reported |
| Boston Medical Center Health Plan | Boston Accountable Care Organization in partnership with BMC HealthNet Plan | not reported | 107,081 (2018) | 20.9% calculated | not reported |
| Boston Medical Center Health Plan | Boston Medical Center Healthnet Plan | not reported | 1,938 (2022) | 2.7% calculated | not reported |
| Boston Medical Center Health Plan | Mercy Medical Center in partnership with BMC HealthNet Plan | not reported | 28,148 (2018) | 5.5% calculated | not reported |
| Boston Medical Center Health Plan | Signature Healthcare in partnership with BMC HealthNet Plan | not reported | 17,924 (2018) | 3.5% calculated | not reported |
| Boston Medical Center Health Plan | Southcoast Health in partnership with BMC HealthNet Plan | not reported | 16,044 (2018) | 3.1% calculated | not reported |
| Boston Medical Center Health Plan | WellSense Health Plan | not reported | 2,214 (2024) | 2.9% calculated | 3 sanctions, 156 appeals resolved |
| Boston Medical Center Health Plan | Boston Medical HealthNet Plan | not reported | 328 (2017) | 0.7% calculated | not reported |
| not reported | Boston Medical Center Health Plan | not reported | 72,409 (2018) | 40.8% calculated | not reported |
| Centene | Celticare | not reported | 42,256 (2017) | 5.3% calculated | not reported |
| Centene | Senior Whole Health | not reported | 13,393 (2017) | 28.6% calculated | not reported |
| Centene | Senior Whole Health | not reported | 12,464 (2024) | 16.1% calculated | 4 sanctions, 476 appeals resolved |
| Commonwealth Care Alliance | Commonwealth Care Alliance | not reported | 16,523 (2024) | 21.4% calculated | 27 sanctions, 6,018 appeals resolved |
| not reported | Community Care Cooperative, Inc. | not reported | 178,753 (2024) | 66.1% calculated | not reported |
| not reported | Community Care Cooperative | not reported | 139,091 (2020) | 35.6% calculated | not reported |
| not reported | Community Care Cooperative, Inc. | not reported | 158,327 (2022) | 51.7% calculated | not reported |
| not reported | Elder Service Plan of Cambridge Health Alliance | not reported | 610 (2024) | 12.3% calculated | not reported |
| not reported | Elder Service Plan of Harbor Health | not reported | 502 (2024) | 10.1% calculated | not reported |
| not reported | Upham's Elder Service Plan | not reported | 289 (2024) | 5.8% calculated | not reported |
| not reported | Elder Service Plan of Harbor Health | not reported | 457 (2017) | 12.5% calculated | not reported |
| not reported | Elder Service Plan of Cambridge Health Alliance | not reported | 399 (2017) | 10.9% calculated | not reported |
| not reported | Element Care Inc | not reported | 976 (2021) | 19.2% calculated | not reported |
| not reported | Element Care Inc. | not reported | 979 (2017) | 26.7% calculated | not reported |
| not reported | Element Care, Inc. | not reported | 906 (2024) | 18.2% calculated | not reported |
| Elevance | Massachusetts Behavioral Health Partnership | not reported | 453,270 (2017) | 100.0% calculated | not reported |
| Elevance | Massachusetts Behavioral Health Partnership | not reported | 365,663 (2024) | 100.0% calculated | 1 sanctions, 30 appeals resolved |
| Fallon Health | Berkshire Fallon Health Collaborative | not reported | 16,644 (2024) | 2.1% calculated | 390 appeals resolved |
| Fallon Health | Fallon 365 Care | not reported | 31,491 (2024) | 4.1% calculated | 2 sanctions, 494 appeals resolved |
| Fallon Health | Fallon Community Health Plan | not reported | 42,526 (2017) | 5.3% calculated | not reported |
| Fallon Health | Fallon Health-Atrius Health Care Collaborative | not reported | 35,757 (2024) | 4.6% calculated | 540 appeals resolved |
| Fallon Health | Health Collaborative of the Berkshires in partnership with Fallon Health | not reported | 19,616 (2022) | 3.0% calculated | not reported |
| Fallon Health | Reliant Medical Group in partnership with Fallon Health | not reported | 40,248 (2022) | 6.1% calculated | not reported |
| Fallon Health | Wellforce in partnership with Fallon Health | not reported | 60,632 (2022) | 9.2% calculated | not reported |
| Fallon Health | Fallon Health Summit ElderCare | not reported | 1,230 (2019) | 25.2% calculated | not reported |
| Fallon Health | Fallon Health Summit Eldercare | not reported | 1,173 (2024) | 23.6% calculated | not reported |
| Fallon Health | Health Collaborative of the Berkshires in partnership with Fallon Health | not reported | 16,874 (2020) | 2.9% calculated | not reported |
| Fallon Health | NaviCare HMO | not reported | 7,255 (2019) | 11.7% calculated | not reported |
| Fallon Health | Navicare HMO | not reported | 10,041 (2024) | 13.0% calculated | 4 sanctions, 1,049 appeals resolved |
| Fallon Health | Reliant Medical Group in partnership with Fallon Health | not reported | 35,809 (2020) | 6.1% calculated | not reported |
| Fallon Health | Wellforce in partnership with Fallon Health | not reported | 53,816 (2020) | 9.1% calculated | not reported |
| not reported | Fallon Health Summit Eldercare | not reported | 457 (2017) | 12.5% calculated | not reported |
| not reported | Baystate Health Care Alliance in partnership with Health New England | not reported | 40,765 (2020) | 6.9% calculated | not reported |
| not reported | Baystate Health Care Alliance in partnership with Health New England (Be Healthy Partnership) | not reported | 44,111 (2022) | 6.7% calculated | 368 appeals resolved |
| not reported | BeHealthy Partnership Plan | not reported | 45,272 (2024) | 5.8% calculated | not reported |
| not reported | Mass General Brigham Health Plan with Mass General Brigham ACO | not reported | 132,115 (2024) | 17.0% calculated | 974 appeals resolved |
| not reported | Mercy Life Inc | not reported | 244 (2021) | 4.8% calculated | not reported |
| not reported | Mercy Life Inc. | not reported | 204 (2017) | 5.6% calculated | not reported |
| not reported | Mercy Life, Inc. | not reported | 200 (2024) | 4.0% calculated | not reported |
| not reported | Money Follows the Person - Behavioral Health Supports (BFP-BH) | not reported | 360 (2017) | 100.0% calculated | not reported |
| not reported | Money Follows the Person- Behavioral Health Supports (MFP-BH) | not reported | 0 (2018) | not reported | not reported |
| not reported | Navicare HMO | not reported | 5,732 (2017) | 12.3% calculated | not reported |
| not reported | Neighborhood PACE | not reported | 761 (2024) | 15.3% calculated | not reported |
| not reported | Mass General Brigham ACO | not reported | 142,897 (2022) | 100.0% calculated | not reported |
| not reported | Partners HealthCare Choice | not reported | 107,883 (2019) | 30.3% calculated | not reported |
| not reported | Neighborhood Health Plan | not reported | 257,898 (2017) | 32.2% calculated | not reported |
| not reported | Serenity Care PACE Program | not reported | 531 (2024) | 10.7% calculated | not reported |
| not reported | Steward Health Choice | not reported | 128,836 (2020) | 33.0% calculated | not reported |
| not reported | Steward Health Choice | not reported | 91,746 (2024) | 33.9% calculated | not reported |
| Point32Health | Atrius Health in partnership with Tufts Health Public Plans (THPP) | not reported | 34,175 (2020) | 5.8% calculated | not reported |
| Point32Health | Beth Israel Deaconess Care Organization (BIDCO) in partnership with Tufts Health Public Plans (THPP) | not reported | 37,776 (2020) | 6.4% calculated | not reported |
| Point32Health | Boston Children’s Health ACO in partnership with Tufts Health Public Plans (THPP) | not reported | 111,699 (2020) | 19.0% calculated | not reported |
| Point32Health | Cambridge Health Alliance (CHA) in partnership with Tufts Health Public Plans (THPP) | not reported | 29,619 (2020) | 5.0% calculated | not reported |
| Point32Health | Tufts Health Plan | not reported | 12,509 (2024) | 16.2% calculated | 1 sanctions, 641 appeals resolved |
| Point32Health | Atrius Health in partnership with THPP | not reported | 40,028 (2022) | 6.1% calculated | not reported |
| Point32Health | Atrius Health in partnership with Tufts Health Public Plans (THPP) | not reported | 40,028 (2021) | 6.1% calculated | not reported |
| Point32Health | Beth Israel Deaconess Care Organization (BIDCO) in partnership with THPP | not reported | 43,142 (2022) | 6.5% calculated | not reported |
| Point32Health | Beth Israel Deaconess Care Organization (BIDCO) in partnership with Tufts Health Public Plans (THPP) | not reported | 43,142 (2021) | 6.5% calculated | not reported |
| Point32Health | Boston Children’s Health ACO in partnership with THPP | not reported | 121,848 (2022) | 18.5% calculated | not reported |
| Point32Health | Boston Children’s Health ACO in partnership with Tufts Health Public Plans (THPP) | not reported | 121,848 (2021) | 18.5% calculated | not reported |
| Point32Health | Cambridge Health Alliance (CHA) in partnership with Tufts Health Public Plans (THPP) | not reported | 34,014 (2022) | 5.2% calculated | not reported |
| Point32Health | Tufts Health Together | not reported | 29,621 (2024) | 58.9% calculated | 422 appeals resolved |
| Point32Health | Tufts Health Together with Cambridge Health Alliance (CHA) | not reported | 32,395 (2024) | 4.2% calculated | 120 appeals resolved |
| Point32Health | Tufts Health Together with UMass Memorial Health | not reported | 44,374 (2024) | 5.7% calculated | 430 appeals resolved |
| UnitedHealth | United Healthcare | not reported | 23,626 (2022) | 32.7% calculated | not reported |
| UnitedHealth | United Healthcare | not reported | 19,467 (2018) | 34.5% calculated | not reported |
| UnitedHealth | UnitedHealthcare | not reported | 23,589 (2024) | 30.5% calculated | 5 sanctions, 1,317 appeals resolved |
| not reported | Upham's Elder Services Plan | not reported | 276 (2017) | 7.5% calculated | not reported |
| not reported | Boston Medical Center Health Net Plan | not reported | 188,357 (2016) | 22.8% calculated | not reported |
| not reported | Boston Medical Center HealthNet Plan | not reported | 46 (2016) | 0.1% calculated | not reported |
| not reported | Celticare | not reported | 35,728 (2016) | 4.3% calculated | not reported |
| not reported | Commonwealth Care Alliance | not reported | 7,468 (2016) | 17.5% calculated | not reported |
| not reported | Elder Service Plan of Cambridge Health Alliance | not reported | 349 (2016) | 8.6% calculated | not reported |
| not reported | Elder Service Plan of Harbor Health Services | not reported | 460 (2016) | 11.4% calculated | not reported |
| not reported | Element Care, Inc. | not reported | 933 (2016) | 23.0% calculated | not reported |
| not reported | Fallon Community Health Plan | not reported | 30,268 (2016) | 3.7% calculated | not reported |
| not reported | Fallon Health Summit ElderCare | not reported | 1,060 (2016) | 26.2% calculated | not reported |
| not reported | Health New England | not reported | 66,959 (2016) | 8.1% calculated | not reported |
| not reported | Massachusetts Behavioral Health Partnership | not reported | 462,074 (2016) | 100.0% calculated | not reported |
| not reported | Mercy Life Inc. | not reported | 155 (2016) | 3.8% calculated | not reported |
| not reported | Money Follows the Person - Behavioral Supports (BFP-BH) | not reported | 273 (2016) | 100.0% calculated | not reported |
| not reported | Multiple Primary Care Clinicians | not reported | 46,496 (2024) | 100.0% calculated | not reported |
| not reported | Multiple Primary Care Providers | not reported | 391,166 (2016) | 100.0% calculated | not reported |
| not reported | Multiple Primary Care Providers | not reported | 106,929 (2019) | 100.0% calculated | not reported |
| not reported | Multiple Primary Care Providers | not reported | 92,072 (2020) | 100.0% calculated | not reported |
| not reported | Multiple primary care providers | not reported | 112,733 (2021) | 100.0% calculated | not reported |
| not reported | Navicare HMO | not reported | 4,788 (2016) | 11.2% calculated | not reported |
| not reported | Neighborhood Health Plan | not reported | 302,079 (2016) | 36.5% calculated | not reported |
| not reported | Neighborhood PACE | not reported | 477 (2016) | 11.8% calculated | not reported |
| not reported | Neighborhood PACE | not reported | 658 (2020) | 13.3% calculated | not reported |
| not reported | Senior Whole Health | not reported | 11,562 (2016) | 27.1% calculated | not reported |
| not reported | Serenity Care PACE Program | not reported | 469 (2020) | 9.5% calculated | not reported |
| not reported | Serenity Care Pace Program | not reported | 356 (2016) | 8.8% calculated | not reported |
| not reported | Tufts Health Plan | not reported | 204,263 (2016) | 24.7% calculated | not reported |
| not reported | United HealthCare | not reported | 16,715 (2016) | 39.2% calculated | not reported |
| not reported | Upham's Elder Services Plan | not reported | 259 (2016) | 6.4% calculated | not reported |
CMS reported enrollment
CMS reporting years in this file run from 2016 through 2024. Retrieved 2026-11-01. The latest reporting year is 2024, which is behind the retrieval date. Enrollment figures are the CMS cell for that reporting year. Share is calculated from CMS reported total enrollment for that state, program, and year. Precapture does not combine rows. A year missing from a trend was not reported. A plan and region with more than one CMS row in a year has no trend and no year-over-year change. The dataset says a reported 0 may not truly represent 0 when a state suppressed a small count. CMS reported.
Accountable Care Partnership Plans (Comprehensive MCO)
Accountable Care Partnership Plans (Comprehensive MCO) 69
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Atrius Health in partnership with THPP | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Attleboro, Beverly, Boston, Brockton, Falmouth, Framingham. Gardner, Fitchburg, Lawrence, Lowell, Lynn, Malden, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, and Woburn | not reported | not reported | not reported | not reported | 2022: 40,028 |
| Atrius Health in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Attleboro, Beverly, Boston, Brockton, Falmouth, Fitchburg, Framingham, Gardner, Lawrence, Lowell, Lynn, Malden, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, and Woburn Counties | not reported | not reported | not reported | not reported | 2019: 37,296 |
| Atrius Health in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Attleboro, Beverly, Boston, Brockton, Falmouth, Framingham, Gardner, Fitchburg, Lawrence, Lowell, Lynn, Malden, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, Woburn | not reported | not reported | not reported | not reported | 2020: 34,175 |
| Atrius Health in partnership with Tufts Health Public Plans (THPP) | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Attleboro, Beverly, Boston, Brockton, Falmouth, Framingham. Gardner, Fitchburg, Lawrence, Lowell, Lynn, Malden, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, Woburn | not reported | not reported | not reported | not reported | 2018: 31,788; 2021: 40,028 |
| Baystate Health Care Alliance in partnership with Health New England (Be Healthy Partnership) | Health New England, Inc. | Health New England, Inc. | Holyoke, Northampton, Springfield, Westfield | not reported | not reported | not reported | not reported | 2021: 44,111 |
show all 69
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Baystate Health Care Alliance in partnership with Health New England (Be Healthy Partnership) | Health New England, Inc. | Health New England, Inc. | Holyoke, Northampton, Springfield, and Westfield | not reported | not reported | not reported | not reported | 2022: 44,111 |
| Baystate Health Care Alliance in partnership with Health New England | Health New England | Health New England, Inc. | Holyoke, Northampton, Springfield, Westfield | not reported | not reported | not reported | not reported | 2018: 37,474; 2020: 40,765 |
| Baystate Health Care Alliance in partnership with Health New England | Health New England | Health New England, Inc. | Holyoke, Northampton, Springfield, and Westfield Counties | not reported | not reported | not reported | not reported | 2019: 38,687 |
| BeHealthy Partnership Plan | Health New England, Inc. | Health New England, Inc. | Greenfield, Holyoke, Northampton, Springfield, Westfield | CMS reported 45,272 (2024) | 5.8% | -6,384 (-12.4%) | +0.2 pts | 2023: 51,656; 2024: 45,272 |
| Berkshire Fallon Health Collaborative | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Adams, Pittsfield | CMS reported 16,644 (2024) | 2.1% | -3,987 (-19.3%) | -0.1 pts | 2023: 20,631; 2024: 16,644 |
| Beth Israel Deaconess Care Organization (BIDCO) in partnership with THPP | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Attleboro, Barnstable, Beverly, Boston, Brockton, Falmouth, Framingham, Haverhill, Lowell, Lynn, Malden, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, and Waltham | not reported | not reported | not reported | not reported | 2022: 43,142 |
| Beth Israel Deaconess Care Organization (BIDCO) in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Attleboro, Barnstable, Beverly, Boston, Brockton, Falmouth, Framingham, Haverhill, Lowell, Lynn, Malden, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, Woburn | not reported | not reported | not reported | not reported | 2018: 33,629; 2020: 37,776 |
| Beth Israel Deaconess Care Organization (BIDCO) in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Attleboro, Barnstable, Beverly, Boston, Brockton, Falmouth, Framingham, Haverhill, Lowell, Lynn, Malden, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, and Woburn Counties | not reported | not reported | not reported | not reported | 2019: 37,296 |
| Beth Israel Deaconess Care Organization (BIDCO) in partnership with Tufts Health Public Plans (THPP) | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Attleboro, Barnstable, Beverly, Boston, Brockton, Falmouth, Framingham, Haverhill, Lowell, Lynn, Malden, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, | not reported | not reported | not reported | not reported | 2021: 43,142 |
| Boston Accountable Care Organization in partnership with BMC HealthNet Plan | Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Attleboro, Barnstable, Boston, Brockton, Fall River, Falmouth, Greenfield Holyoke, Lynn Malden, New Bedford, Northampton, Plymouth, Quincy, Revere, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn | not reported | not reported | not reported | not reported | 2020: 125,747 |
| Boston Accountable Care Organization in partnership with BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Boston, Brockton, Fall River, Falmouth, Greenfield Holyoke, Lynn Malden, New Bedford, Northampton, Plymouth, Quincy, Revere, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn | not reported | not reported | not reported | not reported | 2021: 141,104 |
| Boston Accountable Care Organization in partnership with BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Boston, Brockton, Fall River, Falmouth, Greenfield Holyoke, Lynn Malden, New Bedford, Northampton, Plymouth, Quincy, Revere, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, and Woburn | not reported | not reported | not reported | not reported | 2022: 141,104 |
| Boston Accountable Care Organization in partnership with BMC HealthNet Plan | Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Attleboro, Boston, Brockton, Fall River, Falmouth, Greenfield, Holyoke, Lynn, Malden, New Bedford, Northampton, Plymouth, Quincy, Revere, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, and Woburn Counties | not reported | not reported | not reported | not reported | 2019: 117,013 |
| Boston Accountable Care Organization in partnership with BMC HealthNet Plan | Boston Medical Health Plan | Boston Medical Health Plan | Attleboro, Boston, Brockton, Fall River, Falmouth, Greenfield, Holyoke, Lynn, Malden, New Bedford, Northampton, Plymouth, Quincy, Revere, Somerville, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn | not reported | not reported | not reported | not reported | 2018: 107,081 |
| Boston Children’s Health ACO in partnership with THPP | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Adams, Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Framingham, Gardner-Fitchburg, Haverhill, Holyoke, Lawrence, Lowell, Lynn, Malden, New Bedford, Northampton, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn, and Worcester | not reported | not reported | not reported | not reported | 2022: 121,848 |
| Boston Children’s Health ACO in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Adams, Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Fitchburg, Framingham, Gardner, Haverhill, Holyoke, Lawrence, Lowell, Lynn, Malden, New Bedford, Northampton, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn, and Worcester Counties | not reported | not reported | not reported | not reported | 2019: 98,229 |
| Boston Children’s Health ACO in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Adams, Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Framingham, Gardner-Fitchburg, Haverhill, Holyoke, Lawrence, Lowell, Lynn, Malden, New Bedford, Northampton, Oak Bluffs, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn, Worcester | not reported | not reported | not reported | not reported | 2020: 111,699 |
| Boston Children’s Health ACO in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Framingham, Haverhill, Holyoke, Lawrence, Lowell, Lynn, Malden, New Bedford, Northampton, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham,Westfield, Woburn, Worcester | not reported | not reported | not reported | not reported | 2018: 83,442 |
| Boston Children’s Health ACO in partnership with Tufts Health Public Plans (THPP) | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Adams, Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Framingham, Gardner-Fitchburg, Haverhill, Holyoke, Lawrence, Lowell, Lynn, Malden, New Bedford, Northampton, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn, Worcester | not reported | not reported | not reported | not reported | 2021: 121,848 |
| Cambridge Health Alliance (CHA) in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Boston, Lynn, Malden, Revere, Salem, Somerville, Waltham, Woburn | not reported | not reported | not reported | not reported | 2020: 29,619 |
| Cambridge Health Alliance (CHA) in partnership with Tufts Health Public Plans (THPP) | Tufts Health Plan | Tufts Health Plan | Boston, Lynn, Malden, Revere, Somerville, Waltham, and Woburn Counties | not reported | not reported | not reported | not reported | 2019: 29,299 |
| Cambridge Health Alliance (CHA) in partnership with Tufts Health Public Plans (THPP) | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Boston, Lynn, Malden, Revere, Somerville, Waltham, Woburn | not reported | not reported | not reported | not reported | 2018: 26,068; 2021: 34,014 |
| Cambridge Health Alliance (CHA) in partnership with Tufts Health Public Plans (THPP) | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Boston, Lynn, Malden, Revere, Somerville, Waltham, and Woburn | not reported | not reported | not reported | not reported | 2022: 34,014 |
| East Boston Neighborhood Health WellSense Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Boston, Lynn, Malden, Revere | CMS reported 26,427 (2024) | 3.4% | not reported | not reported | 2024: 26,427 |
| East Boston Neighborhood Health WellSense Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Boston, Malden, Revere | not reported | not reported | not reported | not reported | 2023: 30,476 |
| Fallon 365 Care | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Framingham, Gardner-Fitchburg, Southbridge, Worcester | CMS reported 31,491 (2024) | 4.1% | -6,749 (-17.6%) | -0.1 pts | 2023: 38,240; 2024: 31,491 |
| Fallon Health-Atrius Health Care Collaborative | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Beverly, Boston, Brockton, Framingham, Lawerence, Lowell, Lynn, Malden, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, Woburn | CMS reported 35,757 (2024) | 4.6% | -5,882 (-14.1%) | +0.1 pts | 2023: 41,639; 2024: 35,757 |
| Health Collaborative of the Berkshires in partnership with Fallon Health | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Adams and Pittsfield | not reported | not reported | not reported | not reported | 2022: 19,616 |
| Health Collaborative of the Berkshires in partnership with Fallon Health | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Adams, Pittsfield | not reported | not reported | not reported | not reported | 2018: 15,461; 2020: 16,874; 2021: 19,616 |
| Health Collaborative of the Berkshires in partnership with Fallon Health | Fallon Health Plan | Fallon Health Plan | Adams and Pittsfield Counties | not reported | not reported | not reported | not reported | 2019: 16,147 |
| Mass General Brigham Health Plan with Mass General Brigham ACO | Mass General Brigham Health Plan, Inc. | Mass General Brigham Health Plan, Inc. | Attleboro, Beverly, Boston, Brockton, Framingham, Gloucester, Greenfield, Haverhill, Holyoke, Lawrence, Lowell, Lynn, Malden, Nantucket, Northampton, Oak Bluffs, Quincy, Revere, Salem, Somerville, Waltham, Westfield, Woburn | CMS reported 132,115 (2024) | 17.0% | -21,268 (-13.9%) | +0.3 pts | 2023: 153,383; 2024: 132,115 |
| Mercy Medical Center in partnership with BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Holyoke, Northampton, Springfield, Westfield | not reported | not reported | not reported | not reported | 2018: 28,148; 2020: 29,502; 2021: 32,117 |
| Mercy Medical Center in partnership with BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Holyoke, Northampton, and Springfield, Westfield | not reported | not reported | not reported | not reported | 2022: 32,117 |
| Mercy Medical Center in partnership with BMC HealthNet Plan | Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Holyoke, Northampton, Springfield, and Westfield Counties | not reported | not reported | not reported | not reported | 2019: 28,382 |
| Merrimack Valley ACO in partnership with AllWays Health Partners (My Care Family) | AllWays Health Partners, Inc. | Allways Health Partners | Haverhill, Lawrence, and Lowell | not reported | not reported | not reported | not reported | 2022: 40,416 |
| Merrimack Valley ACO in partnership with AllWays Health Partners (My Care Family) | AllWays Health Partners, Inc. | Allways Health Partners | Haverhill, Lawrence, Lowell | not reported | not reported | not reported | not reported | 2021: 40,416 |
| Merrimack Valley ACO in partnership with AllWays Health Partners | AllWays Health Partners | Allways Health Partners | Haverhill, Lawrence, and Lowell Counties | not reported | not reported | not reported | not reported | 2019: 33,160 |
| Merrimack Valley ACO in partnership with AllWays Health Partners | Allways Health Partners | Allways Health Partners | Haverhill, Lawrence, Lowell | not reported | not reported | not reported | not reported | 2018: 31,865; 2020: 35,125 |
| Reliant Medical Group in partnership with Fallon Health | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Gardner-Fitchburg, Framingham, Southbridge, Worcester | not reported | not reported | not reported | not reported | 2018: 30,168; 2020: 35,809; 2021: 40,248 |
| Reliant Medical Group in partnership with Fallon Health | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Gardner-Fitchburg, Framingham, Southbridge, and Worcester | not reported | not reported | not reported | not reported | 2022: 40,248 |
| Reliant Medical Group in partnership with Fallon Health | Fallon Health Plan | Fallon Health Plan | Fitchburg, Framingham, Gardner, Southbridge, and Worcester Counties | not reported | not reported | not reported | not reported | 2019: 31,432 |
| Signature Healthcare in partnership with BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Brockton, Plymouth, Quincy, Taunton | not reported | not reported | not reported | not reported | 2020: 19,591; 2021: 22,432 |
| Signature Healthcare in partnership with BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Brockton, Plymouth, Quincy, and Taunton | not reported | not reported | not reported | not reported | 2022: 22,432 |
| Signature Healthcare in partnership with BMC HealthNet Plan | Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Attleboro, Brockton, Plymouth, Quincy, and Taunton Counties | not reported | not reported | not reported | not reported | 2019: 18,097 |
| Signature Healthcare in partnership with BMC HealthNet Plan | Boston Medical Health Plan | Boston Medical Health Plan | Brockton, Plymouth, Quincy, Taunton | not reported | not reported | not reported | not reported | 2018: 17,924 |
| Southcoast Health in partnership with BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Fall River, Falmouth, New Bedford, Plymouth, Taunton, Wareham | not reported | not reported | not reported | not reported | 2018: 16,044; 2020: 17,736; 2021: 20,043 |
| Southcoast Health in partnership with BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Fall River, Falmouth, New Bedford, Plymouth, Taunton, and Wareham | not reported | not reported | not reported | not reported | 2022: 20,043 |
| Southcoast Health in partnership with BMC HealthNet Plan | Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Attleboro, Fall River, Falmouth, New Bedford, Plymouth, Taunton, and Wareham Counties | not reported | not reported | not reported | not reported | 2019: 16,589 |
| Tufts Health Together with Cambridge Health Alliance (CHA) | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Boston, Lynn, Malden, Revere, Salem, Somerville, Waltham, Woburn | CMS reported 32,395 (2024) | 4.2% | -5,178 (-13.8%) | +0.1 pts | 2023: 37,573; 2024: 32,395 |
| Tufts Health Together with UMass Memorial Health | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Athol, Framingham, Gardner-Fitchburg, Southbridge, Worcester | CMS reported 44,374 (2024) | 5.7% | -3,725 (-7.7%) | +0.5 pts | 2023: 48,099; 2024: 44,374 |
| WellSense Beth Israel Lahey Health (BILH) Performance Network ACO | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Beverly, Boston, Brockton, Falmouth, Framingham, Gloucester, Haverhill, Lawrence, Lowell, Lynn, Malden, Plymouth, Quincy, Revere, Salem, Somerville, Taunton, Waltham, Wareham, Woburn | CMS reported 61,075 (2024) | 7.9% | -17,474 (-22.2%) | -0.7 pts | 2023: 78,549; 2024: 61,075 |
| WellSense Boston Children's ACO | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Adams, Athol, Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Framingham, Gardner-Fitchburg, Gloucester, Greenfield, Haverhill, Holyoke, Lawrence, Lowell, Lynn, Malden, Nantucket, New Bedford, Northampton, Oak Bluffs, Orleans, Pittsfield, Plymouth, Quincy, Revere, Salem, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn, Worcester | CMS reported 106,816 (2024) | 13.8% | not reported | not reported | 2024: 106,816 |
| WellSense Boston Children's ACO | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Adams, Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Framingham, Gardner-Fitchburg, Haverhill, Holyoke, Lawrence, Lowell, Lynn, Malden, Nantucket, New Bedford, Northampton, Oak Bluffs, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Southbridge, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn, Worcester | not reported | not reported | not reported | not reported | 2023: 120,515 |
| WellSense Care Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Beverly, Boston, Brockton, Framingham, Haverhill, Lawerence, Lowell, Lynn, Malden, Quincy, Revere, Salem, Somerville, Waltham, Wareham, Woburn | not reported | not reported | not reported | not reported | 2023: 62,607 |
| WellSense Care Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Beverly, Boston, Brockton, Framingham, Haverhill, Lawerence, Lowell, Lynn, Malden, Quincy, Revere, Salem, Somerville, Waltham, Woburn | CMS reported 50,270 (2024) | 6.5% | not reported | not reported | 2024: 50,270 |
| WellSense Community Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Framingham, Holyoke, Malden, New Bedford, Northampton, Oak Bluffs, Orleans, Plymouth, Quincy, Revere, Somerville, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn | CMS reported 126,901 (2024) | 16.4% | not reported | not reported | 2024: 126,901 |
| WellSense Community Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Barnstable, Beverly, Boston, Brockton, Fall River, Falmouth, Framingham, Holyoke, Malden, New Bedford, Northampton, Orleans, Plymouth, Quincy, Revere, Somerville, Springfield, Taunton, Waltham, Wareham, Westfield, Woburn | not reported | not reported | not reported | not reported | 2023: 155,062 |
| WellSense Mercy Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Holyoke, Springfield, Westfield | CMS reported 27,212 (2024) | 3.5% | -5,977 (-18.0%) | -0.1 pts | 2023: 33,189; 2024: 27,212 |
| WellSense Signature Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Brockton, Plymouth, Quincy, Taunton | CMS reported 22,464 (2024) | 2.9% | -1,589 (-6.6%) | +0.3 pts | 2023: 24,053; 2024: 22,464 |
| WellSense Southcoast Alliance | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Attleboro, Fall River, Falmouth, New Bedford, Plymouth, Taunton, Wareham | CMS reported 16,909 (2024) | 2.2% | -4,117 (-19.6%) | -0.1 pts | 2023: 21,026; 2024: 16,909 |
| Wellforce in partnership with Fallon Health | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Attleboro, Barnstable, Beverly, Boston, Falmouth, Framingham, Haverhill, Lawrence, Lowell, Lynn, Malden, Orleans, Quincy, Revere, Salem, Somerville, Waltham, Wareham, Woburn | not reported | not reported | not reported | not reported | 2021: 60,632 |
| Wellforce in partnership with Fallon Health | Fallon Community Health Plan, Inc. | Fallon Community Health Plan, Inc. | Attleboro, Barnstable, Beverly, Boston, Falmouth, Framingham, Haverhill, Lawrence, Lowell, Lynn, Malden, Orleans, Quincy, Revere, Salem, Somerville, Waltham, Wareham, and Woburn | not reported | not reported | not reported | not reported | 2022: 60,632 |
| Wellforce in partnership with Fallon Health | Fallon Health Plan | Fallon Health Plan | Attleboro, Barnstable, Beverly, Boston, Brockton, Falmouth, Framingham, Haverhill, Lawrence, Lowell, Lynn, Malden, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, Woburn | not reported | not reported | not reported | not reported | 2018: 52,821; 2020: 53,816 |
| Wellforce in partnership with Fallon Health | Fallon Health Plan | Fallon Health Plan | Attleboro, Barnstable, Beverly, Boston, Brockton, Falmouth, Framingham, Haverhill, Lawrence, Lowell, Lynn, Malden, Orleans, Plymouth, Quincy, Revere, Salem, Somerville, Waltham, Wareham, and Woburn Counties | not reported | not reported | not reported | not reported | 2019: 51,404 |
Managed Care Organization (Comprehensive MCO)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| BMC HealthNet Plan | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Statewide | not reported | not reported | not reported | not reported | 2021: 43,532; 2022: 43,532 |
| Tufts Health Together | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Berkshire, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Suffolk, and Worcester counties | not reported | not reported | not reported | not reported | 2021: 67,296 |
| Tufts Health Together | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | Berkshire, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Suffolk, and Worcester | not reported | not reported | not reported | not reported | 2022: 67,296 |
| Tufts Health Together | Tufts Health Public Plans, Inc. | Tufts Health Public Plans, Inc. | State-defined MCO regions: Northern, Greater Boston, Central, and Western | CMS reported 29,621 (2024) | 58.9% | -8,551 (-22.4%) | +5.8 pts | 2023: 38,172; 2024: 29,621 |
| WellSense Essential MCO | Boston Medical Center Health Plan, Inc. | Boston Medical Center Health Plan, Inc. | Statewide | CMS reported 20,712 (2024) | 41.1% | -13,078 (-38.7%) | -5.8 pts | 2023: 33,790; 2024: 20,712 |
MassHealth BH/SUD PIHP (BHO only (PIHP and/or PAHP))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Massachusetts Behavioral Health Partnership | Carelon | Elevance | Statewide | not reported | not reported | not reported | not reported | 2022: 624,711; 2023: 469,225 |
MassHealth BH/SUD PIHP (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Massachusetts Behavioral Health Partnership | Carelon | Elevance | Statewide | CMS reported 365,663 (2024) | 100.0% | not reported | not reported | 2016: 462,074; 2017: 453,270; 2018: 528,106; 2020: 552,518; 2021: 624,711; 2024: 365,663 |
MassHealth BH/SUD PIHP and/or PAHP (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Massachusetts Behavioral Health Partnership | Beacon | Beacon | Statewide | not reported | not reported | not reported | not reported | 2019: 530,032 |
MassHealth Managed Care (Comprehensive MCO)
MassHealth Managed Care (Comprehensive MCO) 11
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Boston Medical Center Health Net Plan | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 188,357 |
| Boston Medical Center Health Plan | Boston Medical System | Boston Medical System | Statewide | not reported | not reported | not reported | not reported | 2017: 170,750; 2018: 72,409 |
| Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Statewide | not reported | not reported | not reported | not reported | 2019: 47,768; 2020: 41,930 |
| Celticare | Centene Corporation | Centene | Statewide (excludes islands). | not reported | not reported | not reported | not reported | 2017: 42,256 |
| Celticare | not reported | unmatched | Statewide (Excludes islands) | not reported | not reported | not reported | not reported | 2016: 35,728 |
show all 11
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Fallon Community Health Plan | Fallon Community Health Plan | Fallon Community Health Plan, Inc. | Worcester, Middlesex, Franklin, Hampden, Norfolk, Essex, Middlesex | not reported | not reported | not reported | not reported | 2016: 30,268; 2017: 42,526 |
| Health New England | Baystate Health | Baystate Health | Berkshire, Franklin, Hampden, Hampshire | not reported | not reported | not reported | not reported | 2016: 66,959; 2017: 62,494 |
| Neighborhood Health Plan | Partners Healthcare | Partners Healthcare | Statewide | not reported | not reported | not reported | not reported | 2016: 302,079; 2017: 257,898 |
| Tufts Health Plan | Tufts Health Plan | Tufts Health Plan | Northern, Greater Boston, Central, and Western Regions | not reported | not reported | not reported | not reported | 2019: 64,199; 2020: 61,946 |
| Tufts Health Plan | Tufts Health Plan | Tufts Health Plan | Statewide (excludes islands). | not reported | not reported | not reported | not reported | 2016: 204,263; 2017: 225,003 |
| Tufts Health Plan | Tufts Health Plan | Tufts Health Plan | Statewide (excluding islands) | not reported | not reported | not reported | not reported | 2018: 105,265 |
Money Follows the Person - Behavioral Health Supports (MFP-BH) (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Money Follows the Person - Behavioral Health Supports (BFP-BH) | Money Follows the Person - Behavioral Health Supports (BFP-BH) | Money Follows the Person - Behavioral Health Supports (BFP-BH) | Statewide | not reported | not reported | not reported | not reported | 2017: 360 |
Money Follows the Person - Behavioral Supports (MFP-BH) (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Money Follows the Person - Behavioral Supports (BFP-BH) | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 273 |
Money Follows the Person- Behavioral Health Supports (MFP-BH) (Behavioral Health Organization (BHO) only (PIHP and/or PAHP))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Money Follows the Person- Behavioral Health Supports (MFP-BH) | Money Follows the Person- Behavioral Health Supports (MFP-BH) | Money Follows the Person- Behavioral Health Supports (MFP-BH) | Statewide | not reported | not reported | not reported | not reported | 2018: 0 |
Plan All-Inclusive Care for the Elderly (PACE)
Plan All-Inclusive Care for the Elderly (PACE) 11
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Elder Service Plan of Cambridge Health Alliance | Elder Service Plan | Elder Service Plan | Middlesex, Suffolk | CMS reported 610 (2024) | 12.3% | +50 (+8.9%) | +0.4 pts | 2023: 560; 2024: 610 |
| Elder Service Plan of Harbor Health | Elder Service Plan | Elder Service Plan | 02108, 02445, 02021, 02026, 02048, 02062, 02067, 02072, 02169, 02184, 02186, 02188, 02301, 02322, 02324, 02333, 02334, 02338, 02339, 02341, 02343, 02351, 02359, 02367, 02368, 02370, 02379, 02382, 02458, 02766, 02767, 02780 | CMS reported 502 (2024) | 10.1% | not reported | not reported | 2024: 502 |
| Elder Service Plan of Harbor Health | Elder Service Plan | Elder Service Plan | 02108, 02445, 02021, 02026, 02048, 02062, 02067, 02072, 02169,02184, 02186, 02188,02301, 02322, 02324, 02333, 02334, 02338,02339, 02341, 02343, 02351, 02359, 02367, 02368, 02370, 02379, 02382, 02458, 02766, 02767, 02780 | not reported | not reported | not reported | not reported | 2023: 492 |
| Element Care, Inc. | Element Care, Inc. | Element Care, Inc. | 02176, 02180, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01845, 01801, 01803, 01830, 01833, 01834, 01860, 01864, 01867, 01880, 01887, 01890, 01901, 01906, 01907, 01908, 01913, 01915, 01921, 01923, 01929, 01930, 01936, 01938, 01940, 01944, 01945, 01949, 01950, 01951, 01952, 01960, 01966, 01969, 01970, 01983, 01984, 01985 | CMS reported 906 (2024) | 18.2% | not reported | not reported | 2024: 906 |
| Element Care, Inc. | Element Care, Inc. | Element Care, Inc. | 02176, 02180, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01845, 01801, 01803, 01830, 01833,01834, 01860, 01864, 01867, 01880, 01887, 01890, 01901, 01906, 01907, 01908, 01913, 01915, 01921, 01923, 01929, 01930, 01936, 01938, 01940, 01944, 01945, 01949, 01950, 01951, 01952, 01960, 01966, 01969, 01970, 01983, 01984, 01985 | not reported | not reported | not reported | not reported | 2023: 861 |
show all 11
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Fallon Health Summit Eldercare | Fallon Health Plan | Fallon Health Plan | 01001, 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01034, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01005, 01037, 01068, 01083, 01331, 01366, 01368, 01420, 01430, 01431, 01432, 01440, 01441, 01450, 01451, 01452, 01453, 01460, 01462, 01463, 01464, 01468, 01469, 01475, 01501, 01503, 01504, 01505, 01506, 01507, 01510, 01515, 01516, 01519, 01520, 01523, 01524, 01527, 01529, 01531, 01532, 01534, 01535, 01540, 01541, 01543, 01545, 01550, 01562, 01564, 01566, 01568, 01569, 01570, 01571, 01581, 01583, 01585, 01590, 01601, 01612, 01719, 01720, 01730, 01740, 01741, 01742, 01747, 01749, 01752, 01756, 01757, 01772, 01151, 01845 | not reported | not reported | not reported | not reported | 2023: 1,129 |
| Fallon Health Summit Eldercare | Fallon Health Plan | Fallon Health Plan | 01001, 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01034, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01005, 01037, 01068, 01083, 01331,1366, 01368, 01420, 01430, 01431, 01432, 01440, 01441, 01450, 01451, 01452, 01453, 01460, 01462, 01463, 01464, 01468, 01469, 01475, 01501, 01503, 01504, 01505, 01506, 01507, 01510, 01515, 01516, 01519, 01520, 01523, 01524, 01527, 01529, 01531, 01532, 01534, 01535, 01540, 01541, 01543, 01545, 01550, 01562, 01564, 01566, 01568, 01569, 01570, 01571, 01581, 01583, 01585, 01590, 01601, 01612, 01719, 01720, 01730, 01740, 01741, 01742, 01747, 01749, 01752, 01756, 01757, 01772, 01151, 01845 | CMS reported 1,173 (2024) | 23.6% | not reported | not reported | 2024: 1,173 |
| Mercy Life, Inc. | Mercy Life, Inc. | Mercy Life, Inc. | 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01151, 01002, 01027, 01350, 01002, 01007, 01012, 01026, 01032, 01035, 01038, 01050, 01060, 01070, 01082, 01096, 01098, 01243, 01034 | CMS reported 200 (2024) | 4.0% | -12 (-5.7%) | -0.5 pts | 2023: 212; 2024: 200 |
| Neighborhood PACE | Neighborhood PACE | Neighborhood PACE | Middlesex, Suffolk | CMS reported 761 (2024) | 15.3% | +46 (+6.4%) | +0.2 pts | 2023: 715; 2024: 761 |
| Serenity Care PACE Program | Serenity Care PACE Program | Serenity Care PACE Program | 01002, 01027, 01350, 01001, 01002, 01007, 01008, 01010, 01011, 01012, 01013, 01026, 01027, 01028, 01032, 01033, 01034, 01035, 01036, 01038, 01040, 01050, 01056, 01057, 01060, 01069, 01070, 01071, 01073, 01075, 01077, 01081, 01082, 01085, 01089, 01095, 01096, 01098, 01101, 01106, 01151, 01243, 01521, 01009, 01030, 01039, 01053, 01054, 01059, 01062, 01066, 01072, 01079, 01080, 01084, 01088, 01093, 01097, 01301, 01330, 01337, 01338, 01339, 01340, 01341, 01342, 01344, 01346, 01351, 01354, 01355, 01360, 01364, 01367, 01370, 01375, 01378, 01379 | CMS reported 531 (2024) | 10.7% | +24 (+4.7%) | -0.0 pts | 2023: 507; 2024: 531 |
| Upham's Elder Service Plan | Elder Service Plan | Elder Service Plan | 02108, 02445 | CMS reported 289 (2024) | 5.8% | +28 (+10.7%) | +0.3 pts | 2023: 261; 2024: 289 |
Plan All-Inclusive Care for the Elderly (PACE) (Program of All-inclusive Care for the Elderly (PACE))
Plan All-Inclusive Care for the Elderly (PACE) (Program of All-inclusive Care for the Elderly (PACE)) 8
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Elder Service Plan of Cambridge Health Alliance | Elder Service Plan | Elder Service Plan | Middlesex and Suffolk counties | not reported | not reported | not reported | not reported | 2021: 591 |
| Elder Service Plan of Harbor Health | Elder Service Plan | Elder Service Plan | 02108, 02445, 02021, 02026, 02048, 02062, 02067, 02072, 02169, 02184, 02186, 02188, 02301, 02322, 02324, 02333, 02334, 02338, 02339, 02341, 02343, 02351, 02359, 02367, 02368, 02370, 02379, 02382, 02458, 02766, 02767, 02780 | not reported | not reported | not reported | not reported | 2021: 562 |
| Element Care Inc | Element Care Inc | Element Care, Inc. | 02176, 02180, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01845, 01801, 01803, 01830, 01833, 01834, 01860, 01864, 01867, 01880, 01887, 01890, 01901, 01906, 01907, 01908, 01913, 01915, 01921, 01923, 01929, 01930, 01936, 01938, 01940, 01944, 01945, 01949, 01950, 01951, 01952, 01960, 01966, 01969, 01970, 01983, 01984, 01985 | not reported | not reported | not reported | not reported | 2021: 976 |
| Fallon Health Summit Eldercare | Fallon Health Plan | Fallon Health Plan | 01001, 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01034, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01005, 01037, 01068, 01083, 01331, 01331, 01366, 01368, 01420, 01430, 01431, 01432, 01440, 01441, 01450, 01451, 01452, 01453, 01460, 01462, 01463, 01464, 01468, 01469, 01475, 01501, 01503, 01504, 01505, 01506, 01507, 01510, 01515, 01516, 01519, 01520, 01523, 01524, 01527, 01529, 01531, 01532, 01534, 01535, 01540, 01541, 01543, 01545, 01550, 01562, 01564, 01566, 01568, 01569, 01570, 01571, 01581, 01583, 01585, 01590, 01601, 01612, 01719, 01720, 01730, 01740, 01741, 01742, 01747, 01749, 01752, 01756, 01757, 01772, 01151, 01845 | not reported | not reported | not reported | not reported | 2021: 1,175 |
| Mercy Life Inc | Mercy Life Inc | Mercy Life, Inc. | 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01151, 01002, 01027, 01350, 01002, 01007, 01012, 01026, 01032, 01035, 01038, 01050, 01060, 01070, 01082, 01096, 01098, 01243, 01034 | not reported | not reported | not reported | not reported | 2021: 244 |
show all 8
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Neighborhood PACE | Neighborhood PACE | Neighborhood PACE | Middlesex and Suffolk counties | not reported | not reported | not reported | not reported | 2021: 771 |
| Serenity Care PACE Program | Serenity Care PACE Program | Serenity Care PACE Program | 01002, 01027, 01350, 01001, 01002, 01007, 01008, 01010, 01011, 01012, 01013, 01026, 01027, 01028, 01032, 01033, 01034, 01035, 01036, 01038, 01040, 01050, 01056, 01057, 01060, 01069, 01070, 01071, 01073, 01075, 01077, 01081, 01082, 01085, 01089, 01095, 01096, 01098, 01101, 01106, 01151, 01243, 01521, 01009, 01030, 01039, 01053, 01054, 01059, 01062, 01066, 01072, 01079, 01080, 01084, 01088, 01093, 01097, 01301, 01330, 01337, 01338, 01339, 01340, 01341, 01342, 01344, 01346, 01351, 01354, 01355, 01360, 01364, 01367, 01370, 01375, 01378, 01379 | not reported | not reported | not reported | not reported | 2021: 496 |
| Upham's Elder Service Plan | Elder Service Plan | Elder Service Plan | 02108, 02445 | not reported | not reported | not reported | not reported | 2021: 265 |
Primary Care ACO (PCCM Entity)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Community Care Cooperative, Inc. | Community Care Health Plan (WI) | Community Care Health Plan (WI) | Statewide | not reported | not reported | not reported | not reported | 2022: 158,327 |
| Steward Health Choice | Steward Medicaid Care Network, Inc. | Steward Medicaid Care Network, Inc. | Statewide | not reported | not reported | not reported | not reported | 2022: 147,897 |
Primary Care Accountable Care Organization (PCCM Entity)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Community Care Cooperative, Inc. | Community Care Cooperative, Inc. | Community Care Cooperative, Inc. | Statewide | CMS reported 178,753 (2024) | 66.1% | -38,761 (-17.8%) | +1.4 pts | 2023: 217,514; 2024: 178,753 |
| Steward Health Choice | Steward Medicaid Care Network, Inc. | Steward Medicaid Care Network, Inc. | Statewide | CMS reported 91,746 (2024) | 33.9% | -27,220 (-22.9%) | -1.4 pts | 2023: 118,966; 2024: 91,746 |
Primary Care Accountable Care Organization (Primary Care ACO) (PCCM Entity)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Mass General Brigham ACO | Partners HealthCare Choice | Partners HealthCare Choice | Statewide | not reported | not reported | not reported | not reported | 2022: 142,897 |
Primary Care Accountable Care Organization (Primary Care ACO) (Primary Care Case Management Entity (PCCM Entity))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Community Care Cooperative, Inc. | Community Care Health Plan (WI) | Community Care Health Plan (WI) | Statewide | not reported | not reported | not reported | not reported | 2021: 158,327 |
| Mass General Brigham ACO | Partners HealthCare Choice | Partners HealthCare Choice | Statewide | not reported | not reported | not reported | not reported | 2021: 142,897 |
| Steward Health Choice | Steward Medicaid Care Network, Inc. | Steward Medicaid Care Network, Inc. | Statewide | not reported | not reported | not reported | not reported | 2021: 147,897 |
Primary Care Accountable Care Organizations (Primary Care ACO) (Primary Care Case Management Entity (PCCM Entity))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Community Care Cooperative | Community Care Health Plan (WI) | Community Care Health Plan (WI) | Statewide | not reported | not reported | not reported | not reported | 2018: 112,875; 2019: 124,974; 2020: 139,091 |
| Mass General Brigham ACO | Partners HealthCare Choice | Partners HealthCare Choice | Statewide | not reported | not reported | not reported | not reported | 2020: 122,836 |
| Partners HealthCare Choice | Partners HealthCare Choice | Partners HealthCare Choice | Statewide | not reported | not reported | not reported | not reported | 2018: 105,032; 2019: 107,883 |
| Steward Health Choice | Steward Health Choice | Steward Health Choice | Statewide | not reported | not reported | not reported | not reported | 2018: 121,443; 2019: 123,396; 2020: 128,836 |
Primary Care Clinician Plan (Primary Care Case Management (PCCM))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Multiple Primary Care Providers | Multiple Primary Care Providers | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 391,166; 2017: 393,076; 2019: 106,929 |
Primary Care Clinician Program (PCC Plan) (Primary Care Case Management (PCCM))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Multiple Primary Care Providers | Multiple Primary Care Provider (PCCM) | unmatched | Statewide | not reported | not reported | not reported | not reported | 2018: 119,512 |
Primary Care Clinician Program (PCCM)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Multiple Primary Care Clinicians | Multiple Primary Care Clinicians (PCCM) | unmatched | Statewide | CMS reported 46,496 (2024) | 100.0% | -14,665 (-24.0%) | 0.0 pts | 2022: 112,733; 2023: 61,161; 2024: 46,496 |
Primary Care Clinician Program (Primary Care Case Management (PCCM))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Multiple Primary Care Providers | Multiple Primary Care Provider (PCCM) | unmatched | Statewide | not reported | not reported | not reported | not reported | 2020: 92,072 |
| Multiple primary care providers | Multiple Primary Care Clinicians (PCCM) | unmatched | Statewide | not reported | not reported | not reported | not reported | 2021: 112,733 |
Program of All-Inclusive Care for the Elderly (PACE)
Program of All-Inclusive Care for the Elderly (PACE) 14
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Elder Service Plan of Cambridge Health Alliance | Elder Service Plan | Elder Service Plan | Middlesex and Suffolk Counties | not reported | not reported | not reported | not reported | 2020: 658 |
| Elder Service Plan of Cambridge Health Alliance | Elder Service Plan | Elder Service Plan | Middlesex and Suffolk | not reported | not reported | not reported | not reported | 2022: 591 |
| Elder Service Plan of Harbor Health | Elder Service Plan | Elder Service Plan | 02108, 02445, 02021, 02026, 02048, 02062, 02067, 02072, 02169, 02184, 02186, 02188, 02301, 02322, 02324, 02333, 02334, 02338, 02339, 02341, 02343, 02351, 02359, 02367, 02368, 02370, 02379, 02382, 02458, 02766, 02767, 02780 | not reported | not reported | not reported | not reported | 2020: 470; 2022: 562 |
| Element Care Inc | Element Care Inc | Element Care, Inc. | 02176, 02180, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01845, 01801, 01803, 01830, 01833, 01834, 01860, 01864, 01867, 01880, 01887, 01890, 01901, 01906, 01907, 01908, 01913, 01915, 01921, 01923, 01929, 01930, 01936, 01938, 01940, 01944, 01945, 01949, 01950, 01951, 01952, 01960, 01966, 01969, 01970, 01983, 01984, 01985 | not reported | not reported | not reported | not reported | 2020: 961 |
| Element Care, Inc. | Element Care, Inc. | Element Care, Inc. | 02176, 02180, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01845, 01801, 01803, 01830, 01833, 01834, 01860, 01864, 01867, 01880, 01887, 01890, 01901, 01906, 01907, 01908, 01913, 01915, 01921, 01923, 01929, 01930, 01936, 01938, 01940, 01944, 01945, 01949, 01950, 01951, 01952, 01960, 01966, 01969, 01970, 01983, 01984, 01985 | not reported | not reported | not reported | not reported | 2022: 976 |
show all 14
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Fallon Health Summit Eldercare | Fallon Health Plan | Fallon Health Plan | 01001, 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01034, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01005, 01037, 01068, 01083, 01331, 01366, 01368, 01420, 01430, 01431, 01432, 01440, 01441, 01450, 01451, 01452, 01453, 01460, 01462, 01463, 01464, 01468, 01469, 01475, 01501, 01503, 01504, 01505, 01506, 01507, 01510, 01515, 01516, 01519, 01520, 01523, 01524, 01527, 01529, 01531, 01532, 01534, 01535, 01540, 01541, 01543, 01545, 01550, 01562, 01564, 01566, 01568, 01569, 01570, 01571, 01581, 01583, 01585, 01590, 01601, 01612, 01719, 01720, 01730, 01740, 01741, 01742, 01747, 01749, 01752, 01756, 01757, 01772, 01151, 01845 | not reported | not reported | not reported | not reported | 2022: 1,175 |
| Fallon Health Summit Eldercare | Fallon Health Plan | Fallon Health Plan | 01001, 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01034, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01005, 01037, 01068, 01083, 01331, 01331, 01366, 01368, 01420, 01430, 01431, 01432, 01440, 01441, 01450, 01451, 01452, 01453, 01460, 01462, 01463, 01464, 01468, 01469, 01475, 01501, 01503, 01504, 01505, 01506, 01507, 01510, 01515, 01516, 01519, 01520, 01523, 01524, 01527, 01529, 01531, 01532, 01534, 01535, 01540, 01541, 01543, 01545, 01550, 01562, 01564, 01566, 01568, 01569, 01570, 01571, 01581, 01583, 01585, 01590, 01601, 01612, 01719, 01720, 01730, 01740, 01741, 01742, 01747, 01749, 01752, 01756, 01757, 01772, 01151, 01845 | not reported | not reported | not reported | not reported | 2020: 1,170 |
| Mercy Life Inc | Mercy Life Inc | Mercy Life, Inc. | 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01151, 01002, 01027, 01350, 01002, 01007, 01012, 01026, 01032, 01035, 01038, 01050, 01060, 01070, 01082, 01096, 01098, 01243, 01034 | not reported | not reported | not reported | not reported | 2020: 299 |
| Mercy Life, Inc. | Mercy Life, Inc. | Mercy Life, Inc. | 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01151, 01002, 01027, 01350, 01002, 01007, 01012, 01026, 01032, 01035, 01038, 01050, 01060, 01070, 01082, 01096, 01098, 01243, 01034 | not reported | not reported | not reported | not reported | 2022: 244 |
| Neighborhood PACE | Neighborhood PACE | Neighborhood PACE | Middlesex and Suffolk | not reported | not reported | not reported | not reported | 2022: 771 |
| Neighborhood PACE | PACE | unmatched | Middlesex and Suffolk Counties | not reported | not reported | not reported | not reported | 2020: 658 |
| Serenity Care PACE Program | PACE | unmatched | 01002, 01027, 01350, 01001, 01002, 01007, 01008, 01010, 01011, 01012, 01013, 01026, 01027, 01028, 01032, 01033, 01034, 01035, 01036, 01038, 01040, 01050, 01056, 01057, 01060, 01069, 01070, 01071, 01073, 01075, 01077, 01081, 01082, 01085, 01089, 01095, 01096, 01098, 01101, 01106, 01151, 01243, 01521, 01009, 01030, 01039, 01053, 01054, 01059, 01062, 01066, 01072, 01079, 01080, 01084, 01088, 01093, 01097, 01301, 01330, 01337, 01338, 01339, 01340, 01341, 01342, 01344, 01346, 01351, 01354, 01355, 01360, 01364, 01367, 01370, 01375, 01378, 01379 | not reported | not reported | not reported | not reported | 2020: 469 |
| Serenity Care PACE Program | Serenity Care PACE Program | Serenity Care PACE Program | 01002, 01027, 01350, 01001, 01002, 01007, 01008, 01010, 01011, 01012, 01013, 01026, 01027, 01028, 01032, 01033, 01034, 01035, 01036, 01038, 01040, 01050, 01056, 01057, 01060, 01069, 01070, 01071, 01073, 01075, 01077, 01081, 01082, 01085, 01089, 01095, 01096, 01098, 01101, 01106, 01151, 01243, 01521, 01009, 01030, 01039, 01053, 01054, 01059, 01062, 01066, 01072, 01079, 01080, 01084, 01088, 01093, 01097, 01301, 01330, 01337, 01338, 01339, 01340, 01341, 01342, 01344, 01346, 01351, 01354, 01355, 01360, 01364, 01367, 01370, 01375, 01378, 01379 | not reported | not reported | not reported | not reported | 2022: 496 |
| Upham's Elder Service Plan | Elder Service Plan | Elder Service Plan | 02108, 02445 | not reported | not reported | not reported | not reported | 2020: 270; 2022: 265 |
Program of All-Inclusive Care for the Elderly (PACE) (Program of All-inclusive Care for the Elderly (PACE))
Program of All-Inclusive Care for the Elderly (PACE) (Program of All-inclusive Care for the Elderly (PACE)) 23
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Elder Service Plan of Cambridge Health Alliance | Elder Service Plan | Elder Service Plan | Middlesex and Suffolk Counties | not reported | not reported | not reported | not reported | 2016: 349; 2018: 428; 2019: 469 |
| Elder Service Plan of Cambridge Health Alliance | Elder Services Plan of Cambridge Health Alliance | Elder Services Plan of Cambridge Health Alliance | 02108, 02148, 02149, 02150, 02153, 02129, 02134, 02135, 02138, 02143, 02471, 02474, 02151, 02452, 02478, 02479 | not reported | not reported | not reported | not reported | 2017: 399 |
| Elder Service Plan of Harbor Health Services | not reported | unmatched | Middlesex, Norfolk and Suffolk Counties | not reported | not reported | not reported | not reported | 2016: 460 |
| Elder Service Plan of Harbor Health | Elder Service Plan | Elder Service Plan | 02108, 02445, 02021, 02026 ,02048 ,02062 ,02067, 02072, 02169, 02184, 02186, 02188, 02301, 02322, 02324, 02333, 02334, 02338, 02339 ,02341 ,02343, 02351, 02359, 02367, 02368, 02370, 02379, 02382, 02458, 02766, 02767, 02780 | not reported | not reported | not reported | not reported | 2017: 457; 2018: 475 |
| Elder Service Plan of Harbor Health | Elder Service Plan | Elder Service Plan | 02108, 02445, 02021, 02026, 02048, 02062, 02067, 02072, 02169, 02184, 02186, 02188, 02301, 02322, 02324, 02333, 02334, 02338, 02339, 02341, 02343, 02351, 02359, 02367, 02368, 02370, 02379, 02382, 02458, 02766, 02767, 02780 | not reported | not reported | not reported | not reported | 2019: 512 |
show all 23
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Element Care Inc. | Element Care Inc. | Element Care, Inc. | 02176, 02180, 01810, 01821, ,01824 ,01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01845, 01801, 01803, 01830, 01833, 01834 ,01860, 01864, 01867 ,01880, 01887, 01890 ,01901, 01906, 01907, 01908,01913 ,01915, 01921, 01923 ,01929, 01930, 01936, 01938 ,01940 ,01944, 01945, 01949 ,01950 ,01951, 01952, 01960, 01966 ,01969, 01970, 01983, 01984, 01985 | not reported | not reported | not reported | not reported | 2017: 979 |
| Element Care Inc | Element Care Inc | Element Care, Inc. | 02176, 02180, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01845, 01801, 01803, 01830, 01833, 01834, 01860, 01864, 01867, 01880, 01887, 01890, 01901, 01906, 01907, 01908, 01913, 01915, 01921, 01923, 01929, 01930, 01936, 01938, 01940, 01944, 01945, 01949, 01950 ,01951, 01952, 01960, 01966, 01969, 01970, 01983, 01984, 01985 | not reported | not reported | not reported | not reported | 2018: 994 |
| Element Care, Inc. | Element Care, Inc. | Element Care, Inc. | 02176, 02180, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01845, 01801, 01803, 01830, 01833, 01834, 01860, 01864, 01867, 01880, 01887, 01890, 01901, 01906, 01907, 01908, 01913, 01915, 01921, 01923, 01929, 01930, 01936, 01938, 01940, 01944, 01945, 01949, 01950, 01951, 01952, 01960, 01966, 01969, 01970, 01983, 01984, 01985 | not reported | not reported | not reported | not reported | 2019: 1,048 |
| Element Care, Inc. | not reported | unmatched | Essex and Middlesex Counties | not reported | not reported | not reported | not reported | 2016: 933 |
| Fallon Health Summit ElderCare | Fallon Health Plan | Fallon Health Plan | 01001, 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01034, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01005, 01037, 01068, 01083, 01331, 01331, 01366, 01368, 01420, 01430, 01431, 01432, 01440, 01441, 01450, 01451, 01452, 01453, 01460, 01462, 01463, 01464, 01468, 01469, 01475, 01501, 01503, 01504, 01505, 01506, 01507, 01510, 01515, 01516, 01519, 01520, 01523, 01524, 01527, 01529, 01531, 01532, 01534, 01535, 01540, 01541, 01543, 01545, 01550, 01562, 01564, 01566, 01568, 01569, 01570, 01571, 01581, 01583, 01585, 01590, 01601, 01612, 01719, 01720, 01730, 01740, 01741, 01742, 01747, 01749, 01752, 01756, 01757, 01772, 01151, 01845 | not reported | not reported | not reported | not reported | 2019: 1,230 |
| Fallon Health Summit ElderCare | not reported | unmatched | Hampden, Hampshire, Middlesex and Worcester Counties | not reported | not reported | not reported | not reported | 2016: 1,060 |
| Fallon Health Summit Eldercare | Fallon Health Plan | Fallon Health Plan | 01001, 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01034, 01810, 01821, 01824, 01826, 01827, 01840, 01844, 01850, 01876, 01879, 01886, 01005, 01037, 01068, 01083, 01331, 01331, 01366, 01368, 01420, 01430, 01431, 01432, 01440, 01441, 01450, 01451, 01452, 01453, 01460, 01462, 01463, 01464, 01468, 01469, 01475, 01501, 01503, 01504, 01505, 01506, 01507, 01510, 01515, 01516, 01519, 01520, 01523, 01524, 01527, 01529, 01531, 01532, 01534, 01535, 01540, 01541, 01543, 01545, 01550, 01562, 01564, 01566, 01568, 01569, 01570, 01571, 01581, 01583, 01585, 01590, 01601, 01612, 01719, 01720, 01730, 01740, 01741, 01742, 01747, 01749, 01752, 01756, 01757, 01772, 01151, 01845 | not reported | not reported | not reported | not reported | 2017: 457; 2018: 1,173 |
| Mercy Life Inc. | Mercy Life Inc. | Mercy Life, Inc. | 01008, 01010 ,01011 ,01013, 01027, 01028, 01033, 01034 ,01036, 01040, 01056, 01057 ,01069 ,01071, 01073 ,01075, 01077, 01081, 01085, 01089, 01095 ,01101, 01106, 01521, 01151, 01002, 01027, 01350, 01002, 01007, 01012, 01026, 01032 ,01035, 01038, 01050, 01060, 01070, 01082 ,01096, 01098, 01243, 01034 | not reported | not reported | not reported | not reported | 2017: 204 |
| Mercy Life Inc. | not reported | unmatched | Hampden and Hampshire County | not reported | not reported | not reported | not reported | 2016: 155 |
| Mercy Life Inc | Mercy Life Inc | Mercy Life, Inc. | 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01151, 01002, 01027, 01350, 01002, 01007, 01012, 01026, 01032, 01035, 01038, 01050, 01060, 01070, 01082, 01096, 01098, 01243, 01034 | not reported | not reported | not reported | not reported | 2018: 234 |
| Mercy Life, Inc. | Mercy Life, Inc. | Mercy Life, Inc. | 01008, 01010, 01011, 01013, 01027, 01028, 01033, 01034, 01036, 01040, 01056, 01057, 01069, 01071, 01073, 01075, 01077, 01081, 01085, 01089, 01095, 01101, 01106, 01521, 01151, 01002, 01027, 01350, 01002, 01007, 01012, 01026, 01032, 01035, 01038, 01050, 01060, 01070, 01082, 01096, 01098, 01243, 01034 | not reported | not reported | not reported | not reported | 2019: 231 |
| Neighborhood PACE | Neighborhood PACE | Neighborhood PACE | 02151, 02176, 02180, 02148, 02149, 02150, 02153, 02152, 02228 | not reported | not reported | not reported | not reported | 2017: 518 |
| Neighborhood PACE | PACE | unmatched | Middlesex and Suffolk Counties | not reported | not reported | not reported | not reported | 2016: 477; 2018: 551; 2019: 643 |
| Serenity Care PACE Program | PACE | unmatched | 01002, 01027, 01350, 01001, 01002, 01007, 01008, 01010, 01011, 01012, 01013, 01026, 01027, 01028, 01032, 01033, 01034, 01035, 01036, 01038, 01040, 01050, 01056, 01057, 01060, 01069, 01070, 01071, 01073, 01075, 01077, 01081, 01082, 01085, 01089, 01095, 01096, 01098, 01101, 01106, 01151, 01243, 01521, 01009, 01030, 01039, 01053, 01054, 01059, 01062, 01066, 01072, 01079, 01080, 01084, 01088, 01093, 01097, 01301, 01330, 01337, 01338, 01339, 01340, 01341, 01342, 01344, 01346, 01351, 01354, 01355, 01360, 01364, 01367, 01370, 01375, 01378, 01379 | not reported | not reported | not reported | not reported | 2017: 374; 2018: 391; 2019: 487 |
| Serenity Care Pace Program | not reported | unmatched | Franklin, Hampden and Hampshire Counties | not reported | not reported | not reported | not reported | 2016: 356 |
| Upham's Elder Service Plan | Elder Service Plan | Elder Service Plan | 02108, 02445 | not reported | not reported | not reported | not reported | 2018: 276; 2019: 264 |
| Upham's Elder Services Plan | Upham's Elder Service Plan | Upham's Elder Service Plan | 02108, 02445 | not reported | not reported | not reported | not reported | 2017: 276 |
| Upham's Elder Services Plan | not reported | unmatched | Suffolk County | not reported | not reported | not reported | not reported | 2016: 259 |
Senior Care Options (Comprehensive MCO + MLTSS)
Senior Care Options (Comprehensive MCO + MLTSS) 34
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Boston Medical Center HealthNet Plan | Suffolk County | not reported | not reported | not reported | not reported | 2016: 46; 2019: 1,395 |
| Boston Medical Center Healthnet Plan | Boston Medical Center Healthnet Plan | Boston Medical Center HealthNet Plan | Barnstable, Bristol, Hampden, Plymouth, and Suffolk Counties | not reported | not reported | not reported | not reported | 2020: 1,521 |
| Boston Medical Center Healthnet Plan | Boston Medical Health Plan | Boston Medical Health Plan | Suffolk County | not reported | not reported | not reported | not reported | 2018: 844; 2022: 1,938 |
| Boston Medical Center Healthnet Plan | Boston Medical Health Plan | Boston Medical Health Plan | Suffolk | not reported | not reported | not reported | not reported | 2021: 1,938 |
| Boston Medical HealthNet Plan | Boston Medical HealthNet Plan | Boston Medical HealthNet Plan | Suffolk County | not reported | not reported | not reported | not reported | 2017: 328 |
show all 34
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Commonwealth Care Alliance | Commonwealth Care Alliance | Commonwealth Care Alliance | 01330, 01337, 01338, 01339, 01340, 01341, 01342, 01344, 01354, 01301, 01302, 01039, 01346, 01347, 01054, 01349, 01350, 01351, 01360, 01367, 01369, 01370, 01072, 01373, 01375, 01376, 01379, 01380, 01093, 02322, 02157, 02457, 02184, 02185, 02146, 02445, 02446, 02147, 02447, 02021, 02467, 02025, 02026, 02027, 02030, 02032, 02035, 02343, 02052, 02053, 02054, 02186, 02187, 02192, 02194, 02492, 02494, 02056, 02171, 02062, 02762, 02169, 02170, 02171, 02269, 02368, 02067, 02070, 02071, 02072, 02081, 02181, 02481, 02482, 02090, 02188, 02189, 02190 | not reported | not reported | not reported | not reported | 2021: 13,620 |
| Commonwealth Care Alliance | Commonwealth Care Alliance | Commonwealth Care Alliance | 01330, 01337, 01338, 01339, 01340, 01341, 01342, 01344, 01354, 01301, 01302, 01039, 01346, 01347, 01054, 01349, 01350, 01351, 01360, 01367, 01369, 01370, 01072, 01373, 01375, 01376, 01379, 01380, 01093, 02322, 02157, 02457, 02184, 02185, 02146, 02445, 02446, 02147, 02447, 02021, 02467, 02025, 02026, 02027, 02030, 02032, 02035, 02343, 02052, 02053, 02054, 02186, 02187, 02192, 02194, 02492, 02494, 02056, 02171, 02062, 02762, 02169, 02170, 02171, 02269, 02368, 02067, 02070, 02071, 02072, 02081, 02181, 02481, 02482, 02090, 02188, 02189, 02190 | not reported | not reported | not reported | not reported | 2022: 13,620 |
| Commonwealth Care Alliance | Commonwealth Care Alliance | Commonwealth Care Alliance | 01330, 01337, 01338, 01339, 01340, 01341, 01342, 01344, 01354, 01301, 01302, 01039, 01346, 01347, 01054, 01349, 01350, 01351, 01360, 01367, 01369, 01370, 01072, 01373, 01375, 01376, 01379, 01380, 01093, 02322, 02157, 02457, 02184, 02185, 02146, 02445, 02446, 02147, 02447, 02021, 02467, 02025, 02026, 02027, 02030, 02032, 02035, 02343, 02052, 02053, 02054, 02186, 02187, 02192, 02194, 02492, 02494, 02056, 02171, 02062, 02762, 02169, 02170, 02171, 02269, 02368, 02067, 02070, 02071, 02072, 02081, 02181, 02481, 02482, 02090, 02188, 02189, 02190, 02191, 02170, 02093, 02351, 02020, 02324, 02301, 02302, 02303, 02304, 02305, 02327, 02330, 02332, 02333, 02338, 02339, 02341, 02018, 02043, 02044, 02045, 02364, 02050, 02065, 02346, 02061, 02355, 02059, 02358, 02558, 02359, 02360, 02362, 02367, 02770, 02370, 02040, 02055, 02060, 02066, 02379, 02382 | CMS reported 16,523 (2024) | 21.4% | +1,560 (+10.4%) | +1.2 pts | 2017: 8,594; 2018: 9,947; 2019: 11,182; 2023: 14,963; 2024: 16,523 |
| Commonwealth Care Alliance | Commonwealth Care Alliance | Commonwealth Care Alliance | Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester Counties | not reported | not reported | not reported | not reported | 2020: 11,906 |
| Commonwealth Care Alliance | not reported | unmatched | Bristol, Essex, Franklin, Hampden, Middlesex, Norfolk, Plymouth, Suffolk and Worcester Counties | not reported | not reported | not reported | not reported | 2016: 7,468 |
| NaviCare HMO | Fallon Health Plan | Fallon Health Plan | Barnstable, Bristol, Essex, Franklin, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester Counties | not reported | not reported | not reported | not reported | 2019: 7,255 |
| Navicare HMO | Fallon Health Plan | Fallon Health Plan | Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester Counties | not reported | not reported | not reported | not reported | 2020: 7,893 |
| Navicare HMO | Fallon Health Plan | Fallon Health Plan | Barnstable, Brisol, Essex, Franklin, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester Counties | not reported | not reported | not reported | not reported | 2017: 5,732; 2018: 6,706 |
| Navicare HMO | Fallon Health Plan | Fallon Health Plan | Barnstable, Brisol, Essex, Franklin, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester counties | not reported | not reported | not reported | not reported | 2021: 9,712 |
| Navicare HMO | Fallon Health Plan | Fallon Health Plan | Barnstable, Brisol, Essex, Franklin, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester | not reported | not reported | not reported | not reported | 2022: 9,712 |
| Navicare HMO | Fallon Health Plan | Fallon Health Plan | Barnstable, Bristol, Essex, Franklin, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester | CMS reported 10,041 (2024) | 13.0% | +99 (+1.0%) | -0.4 pts | 2023: 9,942; 2024: 10,041 |
| Navicare HMO | not reported | unmatched | Bristol, Essex, Franklin, Hampden, Middlesex, Norolk, Plymouth, Suffolk and Worcester Counties | not reported | not reported | not reported | not reported | 2016: 4,788 |
| Senior Whole Health | Magellan Health | Centene | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester Counties | not reported | not reported | not reported | not reported | 2017: 13,393; 2018: 14,786; 2019: 15,298; 2020: 15,056 |
| Senior Whole Health | Magellan Health | Centene | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester counties | not reported | not reported | not reported | not reported | 2021: 13,499 |
| Senior Whole Health | Magellan Health | Centene | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester | CMS reported 12,464 (2024) | 16.1% | +192 (+1.6%) | -0.5 pts | 2022: 13,499; 2023: 12,272; 2024: 12,464 |
| Senior Whole Health | not reported | unmatched | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk and Worcester Counties | not reported | not reported | not reported | not reported | 2016: 11,562 |
| Tufts Health Plan | Tufts Health Plan | Tufts Health Plan | Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester Counties | not reported | not reported | not reported | not reported | 2020: 7,418 |
| Tufts Health Plan | Tufts Health Plan | Tufts Health Plan | Barnstable, Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester Counties | not reported | not reported | not reported | not reported | 2017: 518; 2018: 4,714; 2019: 5,935 |
| Tufts Health Plan | Tufts Health Plan | Tufts Health Plan | Barnstable, Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester counties | not reported | not reported | not reported | not reported | 2021: 9,950 |
| Tufts Health Plan | Tufts Health Plan | Tufts Health Plan | Barnstable, Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester | CMS reported 12,509 (2024) | 16.2% | +1,484 (+13.5%) | +1.3 pts | 2022: 9,950; 2023: 11,025; 2024: 12,509 |
| Tufts Health Plan | not reported | unmatched | Counties of Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk and Worcester counties | not reported | not reported | not reported | not reported | 2016: 2,085 |
| United HealthCare | not reported | unmatched | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk and Worcester Counties | not reported | not reported | not reported | not reported | 2016: 16,715 |
| United Healthcare | United Healthcare | UnitedHealth | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk and Worcester Counties | not reported | not reported | not reported | not reported | 2017: 18,216; 2018: 19,467; 2019: 20,741 |
| United Healthcare | United Healthcare | UnitedHealth | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk and Worcester counties | not reported | not reported | not reported | not reported | 2021: 23,626 |
| United Healthcare | United Healthcare | UnitedHealth | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester | not reported | not reported | not reported | not reported | 2022: 23,626 |
| United Healthcare | United Healthcare | UnitedHealth | Bristol, Essex, Hampden,Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester Counties | not reported | not reported | not reported | not reported | 2020: 20,988 |
| UnitedHealthcare | UnitedHealthcare | UnitedHealth | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk and Worcester | CMS reported 23,589 (2024) | 30.5% | not reported | not reported | 2024: 23,589 |
| UnitedHealthcare | UnitedHealthcare | UnitedHealth | Bristol, Essex, Hampden, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester | not reported | not reported | not reported | not reported | 2023: 23,671 |
| WellSense Health Plan | Boston Medical Health Plan | Boston Medical Health Plan | Suffolk | CMS reported 2,214 (2024) | 2.9% | +24 (+1.1%) | -0.1 pts | 2023: 2,190; 2024: 2,214 |
Plan operations (CMS MCPAR)
Counts, rates, dates, and status are the CMS MCPAR cells for that plan, program, and reporting year. The appeal rate is calculated from CMS reported appeals resolved in favor of the enrollee divided by CMS reported appeals resolved. It is not a CMS-published rate. A plan links when the name matches one enrollment plan in that same state and program. Unmatched is shown and is not guessed. A sanction amount is not on this page. Retrieved 2026-11-02. CMS MCPAR.
National plan operations · Federal compliance deadlines
Appeals, grievances, and enrollment share (2024)
Appeals, grievances, and enrollment share (2024) 29
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| Be Healthy Partnership Plan | Health New England, Inc. | Accountable Care Partnership Plan (ACPP) | 179 | 105 | 58.7% calculated | 8 | 2.3% | 3.4% |
| Berkshire Fallon Health Collaborative | Fallon Community Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 163 | 102 | 62.6% calculated | 44 | 0.9% | 1.2% |
| East Boston Neighborhood Health WellSense Alliance | Boston Medical Center Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 35 | 24 | 68.6% calculated | 15 | 1.4% | 2.1% |
| Fallon 365 Care | Fallon Community Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 205 | 134 | 65.4% calculated | 46 | 1.7% | 2.5% |
| Fallon Health-Atrius Health Care Collaborative | Fallon Community Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 316 | 216 | 68.4% calculated | 106 | 1.9% | 2.8% |
show all 29
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| Mass General Brigham Health Plan with Mass General Brigham ACO | Mass General Brigham Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 683 | 311 | 45.5% calculated | 74 | 7% | 10.2% |
| Tufts Health Together with Cambridge Health Alliance (CHA) | Tufts Health Public Plans, Inc. | Accountable Care Partnership Plan (ACPP) | 70 | 36 | 51.4% calculated | 21 | 1.7% | 2.5% |
| Tufts Health Together with UMass Memorial Health | Tufts Health Public Plans, Inc. | Accountable Care Partnership Plan (ACPP) | 241 | 118 | 49.0% calculated | 52 | 2.2% | 3.2% |
| WellSense Beth Israel Lahey Health (BILH) Performance Network ACO | Boston Medical Center Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 446 | 223 | 50.0% calculated | 118 | 3.2% | 4.6% |
| WellSense Boston Children's ACO | Boston Medical Center Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 223 | 153 | 68.6% calculated | 65 | 6.3% | 9.1% |
| WellSense Care Alliance | Boston Medical Center Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 215 | 108 | 50.2% calculated | 73 | 2.7% | 3.9% |
| WellSense Community Alliance | Boston Medical Center Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 375 | 208 | 55.5% calculated | 105 | 6.6% | 9.6% |
| WellSense Mercy Alliance | Boston Medical Center Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 61 | 35 | 57.4% calculated | 32 | 1.4% | 2.1% |
| WellSense Signature Alliance | Boston Medical Center Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 48 | 29 | 60.4% calculated | 23 | 1.2% | 1.7% |
| WellSense Southcoast Alliance | Boston Medical Center Health Plan, Inc. | Accountable Care Partnership Plan (ACPP) | 109 | 59 | 54.1% calculated | 21 | 0.9% | 1.3% |
| Massachusetts Behavioral Health Partnership (MBHP) | Elevance | Behavioral Health Vendor (PIHP) | 21 | 13 | 61.9% calculated | 11 | 19.1% | 27.6% |
| Tufts Health Together | Tufts Health Public Plans, Inc. | Managed Care Organization (MCO) | 206 | 109 | 52.9% calculated | 65 | 1.6% | 2.3% |
| WellSense Essential MCO | Boston Medical Center Health Plan, Inc. | Managed Care Organization (MCO) | 80 | 38 | 47.5% calculated | 47 | 1.1% | 1.6% |
| Commonwealth Care Alliance One Care | Commonwealth Care Alliance | One Care Medicare Medicaid Plan | 2,479 | 976 | 39.4% calculated | 4,509 | 1.4% | 2.1% |
| Tufts One Care | Tufts Health Plan | One Care Medicare Medicaid Plan | 641 | 310 | 48.4% calculated | 629 | 0.4% | 0.5% |
| UnitedHealthcare Connected for One Care | unmatched | One Care Medicare Medicaid Plan | 276 | 190 | 68.8% calculated | 215 | 0.2% | 0.3% |
| Community Care Cooperative | Community Care Health Plan (WI) | Primary Care Accountable Care Organization (PCACO) | not reported | not reported | not reported | not reported | 9.4% | 13.5% |
| Revere Health Choice | unmatched | Primary Care Accountable Care Organization (PCACO) | not reported | not reported | not reported | not reported | 4.8% | 7% |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Senior Care Options (SCO) | 994 | 363 | 36.5% calculated | 2,584 | 0.8% | 1.2% |
| NaviCare SCO | Fallon Health Plan | Senior Care Options (SCO) | 597 | 352 | 59.0% calculated | 618 | 0.5% | 0.7% |
| Senior Whole Health SCO | Centene | Senior Care Options (SCO) | 199 | 133 | 66.8% calculated | 1,911 | 0.6% | 0.9% |
| Tufts Health Plan SCO | unmatched | Senior Care Options (SCO) | 623 | 267 | 42.9% calculated | 2,090 | 0.6% | 0.9% |
| UnitedHealthCare SCO | UnitedHealth | Senior Care Options (SCO) | 607 | 249 | 41.0% calculated | 1,133 | 1.2% | 1.7% |
| Wellsense SCO | Boston Medical Health Plan | Senior Care Options (SCO) | 77 | 50 | 64.9% calculated | 109 | 0.1% | 0.2% |
Sanctions (2024)
Sanctions (2024) 39
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| East Boston Neighborhood Health WellSense Alliance | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
| Fallon 365 Care | Fallon Community Health Plan, Inc. | Other, specify (PCP Network adequacy) | 2023-04-20 | Yes | Yes, remediated |
| WellSense Beth Israel Lahey Health (BILH) Performance Network ACO | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
| WellSense Boston Children's ACO | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
| WellSense Care Alliance | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
show all 39
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| WellSense Community Alliance | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
| WellSense Signature Alliance | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
| WellSense Signature Alliance | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
| WellSense Southcoast Alliance | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
| WellSense Essential MCO | Boston Medical Center Health Plan, Inc. | Performance improvement | 2024-07-22 | No | Yes, remediated |
| Commonwealth Care Alliance One Care | Commonwealth Care Alliance | Financial issues | 2024-10-16 | Yes | Yes, remediated |
| Commonwealth Care Alliance One Care | Commonwealth Care Alliance | Performance improvement | 2024-02-29 | Yes | Yes, remediated |
| Commonwealth Care Alliance One Care | Commonwealth Care Alliance | Other, specify (Marketing) | 2024-10-31 | Yes | Yes, remediated |
| Commonwealth Care Alliance One Care | Commonwealth Care Alliance | Reporting | 2024-04-17 | Yes | Yes, remediated |
| Commonwealth Care Alliance One Care | Commonwealth Care Alliance | Other, specify (Marketing) | 2024-02-15 | Yes | Yes, remediated |
| Commonwealth Care Alliance One Care | Commonwealth Care Alliance | Other, specify (Cost Sharing) | 2024-02-02 | Yes | Yes, remediated |
| Commonwealth Care Alliance One Care | Commonwealth Care Alliance | Other, specify (Benefit Administration) | 2024-02-29 | Yes | Yes, remediated |
| Tufts One Care | Tufts Health Plan | Other, specify (Access to Services--Pharmacies/Prescription Drug) | 2024-08-15 | Yes | Yes, remediated |
| UnitedHealthcare Connected for One Care | unmatched | Timely access | 2024-04-30 | Yes | Yes, remediated |
| UnitedHealthcare Connected for One Care | unmatched | Other, specify (Cost Sharing) | 2024-10-04 | Yes | Yes, remediated |
| UnitedHealthcare Connected for One Care | unmatched | Other, specify (Network Access) | 2024-12-13 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Financial issues | 2024-10-16 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Reporting | 2024-04-17 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Other, specify (Cost Sharing) | 2024-02-02 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Other, specify (Benefit Administration) | 2024-02-29 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Other, specify (Marketing) | 2024-02-29 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Performance improvement | 2024-02-29 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Other, specify (Benefit Administration) | 2024-04-26 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Other, specify (Marketing) | 2024-10-31 | Yes | Yes, remediated |
| Commonwealth Care Alliance SCO | Commonwealth Care Alliance | Other, specify (Marketing) | 2024-10-31 | Yes | Yes, remediated |
| NaviCare SCO | Fallon Health Plan | Other, specify (Timeliness Study) | 2024-06-03 | Yes | Yes, remediated |
| NaviCare SCO | Fallon Health Plan | Other, specify (Formulary Submission and Administration) | 2024-06-26 | Yes | Yes, remediated |
| NaviCare SCO | Fallon Health Plan | Other, specify (Timeliness Study) | 2024-08-20 | Yes | Yes, remediated |
| Senior Whole Health SCO | Centene | Other, specify (Cost Sharing) | 2024-02-14 | Yes | Yes, remediated |
| Senior Whole Health SCO | Centene | Other, specify (Cost Sharing) | 2024-05-13 | Yes | Yes, remediated |
| UnitedHealthCare SCO | UnitedHealth | Timely access | 2024-04-30 | Yes | Yes, remediated |
| UnitedHealthCare SCO | UnitedHealth | Other, specify (Cost Sharing) | 2024-10-04 | Yes | Yes, remediated |
| Wellsense SCO | Boston Medical Health Plan | Other, specify (Formulary Submission and Administration) | 2024-06-26 | Yes | Yes, remediated |
| Wellsense SCO | Boston Medical Health Plan | Other, specify (Payments to Providers) | 2024-09-04 | Yes | Yes, remediated |
Award history
- MassHealth Accountable Care Organizations (ACPP + PCACO) BD-22-1039-EHS01-ASHWA-71410 (22EHSACORFR): awarded. MassHealth Accountable Care Organizations (ACPP + PCACO) (BD-22-1039-EHS01-ASHWA-71410 (22EHSACORFR)). Status recorded from the retrieved documents: awarded. Named awardees in confirmed excerpts: BeHealthy Partnership Plan, Berkshire Fallon Health Collaborative, East Boston Neighborhood Health WellSense Alliance, Fallon 365 Care, Fallon Health Atrius Health Care Collaborative, Mass General Brigham Health Plan with Mass General Brigham ACO, Tufts Health Together with Cambridge Health Alliance (CHA), Tufts Health Together with UMass Memorial Health, and 9 more named in the source. Contract start 2023-04-01.
Retrieved 2026-11-03. Sources and scores
Early procurement signals
No official early-procurement document has been retrieved for this state. This is not a finding that no signal exists. Early signals
Contract amendments
No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments
Medicaid policy
Indiana rows are official policy instruments. Other states show only Federal Register notices of hearings on SPA disapprovals, which are a narrow slice and not waiver or SPA coverage.
Federal Register notices of hearings on SPA disapprovals are read from the Federal Register JSON API. That covers no approved SPAs, waivers, or section 1115 demonstrations.
Coverage not_collected.
No official Medicaid managed-care policy instrument has been retrieved for this state. This is not a finding that no waiver, state plan amendment, or rule exists. Medicaid policy
Federal Register SPA disapproval hearing notices (2015 or later): 0
Plan financials
No official Medicaid plan financial filing has been retrieved for this state. This is not a finding that no filing exists, and it is not a zero. Plan financials. Coverage: not_collected.
Federal compliance deadlines
Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.