What is the waiver?

The 1115 Waiver is the agreement between Massachusetts and the federal government that defines how the Medicaid program is uniquely applied in our state. Every five years, the Waiver is used to create innovative ways of delivering high-quality, accessible care in our state. For instance, the previous agreement helped launch Accountable Care Organizations in Massachusetts, which help simplify the patient experience and control healthcare costs.

How was this initiative formed?

The new waiver program was constructed over the course of several years and through a highly collaborative process between the state’s Executive Office of Health and Human Services, MHA, and hospitals across the commonwealth.

This is a first-in-the nation approach, and one that MHA and our members believe can set a model for other states to follow.

How does the waiver address health equity?

In a groundbreaking move, hospital financial incentives will be directly tied to their ability to address key health equity measures. Reducing health disparities is a long-held priority for Massachusetts hospitals. This plan will take that commitment to the next level by directly connecting health equity into our system’s planning, operations, and financing.

How will this be done?

In order to better understand the needs of all patients and populations, hospitals will begin to ask patients new questions about their background – including their race, ethnicity, English language proficiency/preferred language for healthcare, disability status, sexual orientation, and gender identity.  

Hospitals will use this data to identify health disparities, the root causes of inequities, and ways in which they can close the gaps for people that are not currently getting the level of healthcare they deserve. This is just one in a series of operational changes that hospitals are making to fulfill the equity and quality requirements of the waiver.