BCBS Foundation Releases Latest ‘Facts and Trends” Report on MassHealth

Oct 26, 2022

According to the latest edition of the MassHealth: The BasicsĀ from Blue Cross Blue Shield of Massachusetts Foundation, one out of 10 MassHealth members is age 65 or over.

Most of those MassHealth members are classified at “seniors in community” totaling 174,960 individuals with another 20,300 “seniors in nursing facilities.”The report also notes that approximately 56% of spending in SFY 2021 was for services to people with disabilities and seniors. These groups make up a little over one quarter (25%) of the MassHealth membership.

Over a two-year period, from SFY 2019 to SFY 2021, per member spending unadjusted for inflation increased for all population groups except seniors, according to the report. These increases can be explained by two trends: 1) a significant increase in capitation rates paid by MassHealth beginning midway through SFY 2020, and 2) rebounding utilization in SFY 2021 after the initial COVID-19 lockdown caused a drop in utilization across nearly all service categories (doctors visits, dental care, etc.) During this same time period, per member spending decreased 10% for seniors (about $1,969). One driver of this decrease was a reduction in nursing facility utilization during the COVID-19 pandemic. Since nursing facility care is high cost, this trend reduced the per member spending of the overall senior population.