Slide 1: One Care Member Experience Findings from the 2018-2022 surveys
ForHealth Consulting at UMass Chan Medical School

July 2024

Presented to: (The Massachusetts state seal is shown here.)

Presented by: 
Yara Halasa-Rappel, PhD, DMD
Linda Long-Bellil, PhD, JD
Jianying Zhang, MPH, MD
Slide 2: Background and Research Questions
Note: The ForHealth Consulting logo and the following footnote is shown on this slide and all slides going forward. 
“© 2024. The consulting and operations division of UMass Chan Medical School. Confidential”
Slide 3: Background
•	The One Care financial alignment demonstration integrates Medicaid and Medicare services for working-age dual eligible members with disabilities into managed care organizations (MCOs) that receive capitated payment from Medicare and MassHealth.
o	One Care has been offered through two MCOs, Commonwealth Care Alliance and Tufts, since 2016, and in 2022, MassHealth included a plan offered by UnitedHealthcare as a third option.
•	One Care offered additional services compared to the fee-for-service (FFS) program:
o	Care Coordinator
o	Long-Term Services Coordinator (LTS-C)
o	Individualized Care Plan (ICP)
Slide 4: One Care Member Experience Survey Background
In response to CMS requirements and the One Care Implementation Council’s request to capture and report any perceived change in members’ experience with healthcare services due to the One Care Demonstration, UMass Chan has implemented an annual survey for:
•	A sample of One Care members since 2016 (data collection started in 2017).
•	A sample of working-age dual eligible members enrolled in FFS since 2018 (data collection started in 2019).
Slide 5: Topics Covered in Member Experience Surveys
Note: the following information is shown in two columns on this slide. This is noted here in case the presenter refers to the columns.

Topics Covered in One Care Survey
•	Reason for and ease of enrollment in One Care
•	Members’ care team and satisfaction with their care team
o	Care coordinator
o	LTS-C
o	Utilization of the ICP
•	Assessment and care planning process

Topics Covered in Both One Care and FFS Surveys
•	Members’ care team and satisfaction with their care team
o	Care team is limited to primary care provider/personal doctor for FFS members
•	Assessment of medical, behavioral health (BH), long-term services and supports (LTSS) and transportation and how well those needs were met
•	Overall satisfaction with healthcare experience
Slide 6: COVID-19 Public Health Emergency
•	In March 2020, a COVID-19 Public Health Emergency (PHE) was declared.
•	In response to the COVID-19 PHE, the One Care program required plans to contact all members to identify their needs and facilitate access to personal protective equipment (e.g., masks for those receiving in-home services) and vaccines. 
•	The federal COVID-19 PHE declaration ended on May 11, 2023. 
o	Survey years 2018 and 2019 capture trends in member experience prior to the PHE.
o	Survey years 2020 through 2022 capture trends in member experience during the PHE.
Slide 7: Research Questions
Q1: How well did One Care members rate their experience with their care team compared to dual-eligible members who remain in the FFS program?

Q2: How well does One Care meet its members’ needs for medical and BH, LTSS, and transportation services? 

Q3: What impact does experience with care coordination have on the number of self-reported needs met for medical, BH, LTSS, and transportation services for members enrolled in One Care? 

Q4: What was the impact of the One Care program’s actions during the COVID-19 PHE on members’ reports of how well One Care medical services and LTSS met their needs?
Slide 8: Response Rate and Respondents’ Characteristics
Title slide, no content on this slide.
Slide 9: Response Rate
Note:  The following data is shown in a table on this slide.

MES Survey (Reference Year)	2018
Data collection (Year) 	2019
Number of respondents Overall 	2,646
Response rate Overall 	38.4%
Response rate by program
-	One Care	38.0%
-	FFS	38.8%

MES Survey (Reference Year)	2019
Data collection (Year) 	2020
Number of respondents Overall 	2,853
Response rate Overall 	41.4%
Response rate by program
-	One Care	41.7%
-	FFS	41.0%

MES Survey (Reference Year)	2020
Data collection (Year) 	2021
Number of respondents Overall 	2,485
Response rate Overall 	36.1%
Response rate by program
-	One Care	35.7%
-	FFS	36.5%

MES Survey (Reference Year)	2021
Data collection (Year) 	2022
Number of respondents Overall 	2,234
Response rate Overall 	32.4%
Response rate by program
-	One Care	32.0%
-	FFS	33.0%

MES Survey (Reference Year)	2022
Data collection (Year) 	2023
Number of respondents Overall 	2,188
Response rate Overall 	31.8%
Response rate by program
-	One Care	31.3%
-	FFS	32.5%
Slide 10: Results
Title slide, no content on this slide.
Slide 11: Q1: Experience with Care Team
Title slide, no content on this slide.

Slide 12: Reported Visiting Primary Care Provider/ Personal Doctor in Past 12 Months
Between 2018 and 2022, 96% of One Care and FFS dual-eligible members had a primary care provider (PCP) or personal doctor.

The majority of One Care (91%) and FFS (90%) members reported visiting their PCP in the last 12 months. 

•	There was a significant difference between programs when it comes to visiting PCP in the last 12 months with 8% of One Care members reported not visiting their PCP compared to 9% of FFS members. 
•	There was a slight, but significant, decline in One Care and FFS members who reported visiting their PCP in the last 12 months between 2020 and 2022 – a period that overlaps with the COVID-19 PHE period, and reports of limited access to health providers. 
Note:  The following data is shown in bar charts on this slide.

Program Level
One Care
Yes	91%
No	8%
Don’t know/Not sure	1%

FFS
Yes	90%
No	9%
Don’t know/Not sure	1%

One Care
2018
Yes	96%
No	3%
Don’t know/Not sure	0%

2019
Yes	95%
No	4%
Don’t know/Not sure	1%

2020
Yes	90%
No	9%
Don’t know/Not sure	1%

2021
Yes	89%
No	10%
Don’t know/Not sure	1%

2022
Yes	87%
No	11%
Don’t know/Not sure	2%

FFS
2018
Yes	96%
No	4%
Don’t know/Not sure	0%

2019
Yes	95%
No	5%
Don’t know/Not sure	0%

2020
Yes	89%
No	11%
Don’t know/Not sure	0%

2021
Yes	88%
No	11%
Don’t know/Not sure	1%

2022
Yes	87%
No	12%
Don’t know/Not sure	1%

Question: 
One Care: Have you met with your Primary Care Provider in the past 12 months?
FFS: Have you had a phone, video or in-person visit with your personal doctor in the past 12 months?
Slide 13: Satisfaction with Primary Care Provider/ Personal Doctor

In general, One Care and FFS dual-eligible members were extremely satisfied (73%), or somewhat satisfied (22%) with their PCP.

•	We found no significant difference between One Care and FFS when it comes to the level of satisfaction with their PCP.

Note: The following data is shown in bar graphs on this slide.

One Care
2018
Extremely Satisfied	75%
Somewhat Satisfied	20%
Somewhat Dissatisfied	3%
Extremely Dissatisfied	2%

2019
Extremely Satisfied	74%
Somewhat Satisfied	21%
Somewhat Dissatisfied	3%
Extremely Dissatisfied	2%

2020
Extremely Satisfied	72%
Somewhat Satisfied	22%
Somewhat Dissatisfied	3%
Extremely Dissatisfied	2%

2021
Extremely Satisfied	72%
Somewhat Satisfied	23%
Somewhat Dissatisfied	4%
Extremely Dissatisfied	2%

2022
Extremely Satisfied	72%
Somewhat Satisfied	22%
Somewhat Dissatisfied	4%
Extremely Dissatisfied	2%
FFS
2018
Extremely Satisfied	75%
Somewhat Satisfied	21%
Somewhat Dissatisfied	3%
Extremely Dissatisfied	2%

2019
Extremely Satisfied	73%
Somewhat Satisfied	22%
Somewhat Dissatisfied	3%
Extremely Dissatisfied	2%

2020
Extremely Satisfied	72%
Somewhat Satisfied	23%
Somewhat Dissatisfied	4%
Extremely Dissatisfied	2%

2021
Extremely Satisfied	72%
Somewhat Satisfied	23%
Somewhat Dissatisfied	4%
Extremely Dissatisfied	2%

2022
Extremely Satisfied	72%
Somewhat Satisfied	23%
Somewhat Dissatisfied	4%
Extremely Dissatisfied	2%
Question: 
One Care: How satisfied are you with the Primary Care Provider you have under your One Care plan?
FFS:  How satisfied are you with your personal doctor?
Slide 14: Care Coordination for One Care Member
Have a Care Coordinator
•	The majority of One Care Members reported having a care coordinator
•	A significantly smaller percentage of members reported having a care coordinator in 2019 but this percentage improved in later years 
•	79% of members reported having a care coordinator in 2022, the highest percentage since 2018
•	The percentage of those who did not know if they have a care coordinator was consistent (12% to 13%)

Note: the following data is shown in bar graphs on this slide.

2018
Yes	78%
No	9%
Don’t know/Not sure	12%

2019
Yes	76%
No	12%
Don’t know/Not sure	13%

2020
Yes	78%
No	10%
Don’t know/Not sure	12%

2021
Yes	77%
No	10%
Don’t know/Not sure	13%

2022
Yes	79%
No	9%
Don’t know/Not sure	13%

Question:
Do you have a Care Partner under your One Care plan? 
Slide 15: Care Coordination for One Care Members
Met with Care Coordinator in Past 12 Months
•	The majority of One Care members who had a care coordinator reported meeting with their care coordinator in the past 12 months
•	Starting in 2020, there was a significant 10% increase in the percentage of members who met with their care coordinator compared to 2018 
•	This increase was consistent between 2020 and 2022, a period that overlaps with the COVID-19 PHE
•	Among those who had a care coordinator, the percentage who did not know if they had met with a care coordinator was small and consistent (2%-3%) 
Note: the following data is shown in bar graphs on this slide.

2018
Yes	79%
No	18%
Don’t know/Not sure	3%

2019
Yes	80%
No	17%
Don’t know/Not sure	3%

2020
Yes	89%
No	9%
Don’t know/Not sure	2%

2021
Yes	89%
No	9%
Don’t know/Not sure	2%

2022
Yes	89%
No	8%
Don’t know/Not sure	3%

Question:
Have you had a phone, video or in-person meeting with your Care Partner in the past 12 months?
Slide 16	: Care Coordination for One Care Members
Satisfaction with Care Coordinator
•	The majority of those who had and met with their care coordinator in the last 12 months were either extremely satisfied (70%) or somewhat satisfied (23%) with their care coordinator
•	There was no significant difference in members’ satisfaction across the five study years 
•	The percentage of those who were somewhat dissatisfied (5%) or extremely dissatisfied (3%) was small and consistent across the five study years 

Note: The following data is shown in bar graphs on this slide.

2018
Extremely Satisfied	70%
Somewhat Satisfied	23%
Somewhat Dissatisfied	4%
Extremely Dissatisfied	3%

2019
Extremely Satisfied	71%
Somewhat Satisfied	22%
Somewhat Dissatisfied	4%
Extremely Dissatisfied	2%

2020
Extremely Satisfied	68%
Somewhat Satisfied	24%
Somewhat Dissatisfied	5%
Extremely Dissatisfied	3%

2021
Extremely Satisfied	69%
Somewhat Satisfied	24%
Somewhat Dissatisfied	5%
Extremely Dissatisfied	3%

2022
Extremely Satisfied	70%
Somewhat Satisfied	23%
Somewhat Dissatisfied	4%
Extremely Dissatisfied	3%

Question:
How satisfied are you with your Care Partner?
Slide 17: LTS-C for One Care Member
Met with LTS-C in the Past 12 Months
•	Over the 5-year study period, 48% of One Care members knew their One Care plan offers an LTS coordinator in addition to a care manager.
•	Among those who knew their plan offered an LTS-C in addition to a care coordinator, 25% reported they had an LTS-C and 31% did not know or were not sure if they had an LTS-C. 
•	Among members who reported having an LTS-C, the majority (81% to 88%) reported having contact with an LTS-C in the past 12 months. There were no significant changes over time. 
o	There was an increase in members who met with an LTS coordinator in 2020 and 2021, a period that coincided with the COVID-19 PHE period; however, this improvement was not reflected in 2022. This change was not statistically significant.

Note: the following data is shown in bar graphs on this slide.

2018
Yes	81%
No	12%
Don’t know/Not sure	6%

2019
Yes	83%
No	11%
Don’t know/Not sure	6%

2020
Yes	88%
No	9%
Don’t know/Not sure	3%

2021
Yes	86%
No	10%
Don’t know/Not sure	4%

2022
Yes	81%
No	14%
Don’t know/Not sure	5%
Questions:
Did your One Care plan offer you an LTS Coordinator in addition to a Care Manager?

Do you have an LTS Coordinator in addition to a Care Manager? 

Have you had a phone, video or in-person meeting with your LTS Coordinator in the past 12 months? 
Slide 18: LTS-C for One Care Member
Satisfaction with LTS-C
•	The majority of One Care members who met with their LTS-C were either extremely satisfied (75% 5-year average) or somewhat satisfied (21% 5-year average) with their LTS coordinator.
•	The results were consistent between 2018 and 2022, and there was no significant change in satisfaction level during the study period. 

Note: The following data is shown in bar graphs on this slide.

2018
Extremely satisfied	78%
Somewhat satisfied	18%
Somewhat dissatisfied	2%
Extremely dissatisfied	1%

2019
Extremely satisfied	74%
Somewhat satisfied	22%
Somewhat dissatisfied	3%
Extremely dissatisfied	2%

2020
Extremely satisfied	73%
Somewhat satisfied	22%
Somewhat dissatisfied	3%
Extremely dissatisfied	2%

2021
Extremely satisfied	76%
Somewhat satisfied	20%
Somewhat dissatisfied	2%
Extremely dissatisfied	2%

2022
Extremely satisfied	75%
Somewhat satisfied	21%
Somewhat dissatisfied	3%
Extremely dissatisfied	2%
Question:
Have you had a phone, video or in-person meeting with your LTS Coordinator in the past 12 months? 
Slide 19: Individualized Care Plan
•	Between 2018 and 2022, nearly half of One Care members (54%) reported having an ICP; however, 25% did not know or were not sure if they had one. 
•	Among the 54% of members who reported having an ICP, the majority (80%) had their ICP updated within the last 12 months, received a written copy of their ICP (63%), and agreed with what is in their ICP (91%).
•	However, only 61% reported their care team discussed ways to change their ICP, and 17% did not know or were not sure if the care team discussed this option.
•	In general, those who have an ICP completely agreed (78%) or agreed somewhat (18%) that their ICP includes services they need.
•	Positive but marginal and statistically insignificant changes were observed across the study period.
Questions:
Do you have an Individualized Care Plan that tells you the services you will get under One Care? 

When was your Individualized Care Plan last updated? 

Do you agree with what is in your Individualized Care Plan? 

Did you receive a written copy of your Individualized Care Plan?

Did your Care Team discuss ways to change your Individualized Care Plan, if needed?

Overall, my Individualized Care Plan includes the services I need. 
Slide 20: Q2: How well does One Care meet members’ needs for medical and BH services and LTSS?
Title slide, no content on this slide.
Slide 21: Use and Need for Medical and BH Services
•	Between 2018-2022, One Care members were, on average, significantly more likely than FFS members to use or need: 
o	Prescription medication – 95% vs. 93%
o	Oral health/dental care – 78% vs. 71%
o	Physical, occupational or speech therapy – 24% vs. 20%
o	Mental health services – 53% vs. 48%
•	Between 2018-2022, there was no significant difference, on average, between One Care and FFS members use or need of:
o	Specialist services – 76% for both One Care and FFS
o	Substance use services – 5% for One Care and 6% for FFS members
•	No significant changes over the 5 survey years in either One Care or FFS programs.
Slide 22: Use of and Need for LTSS
•	Between 2018-2022, One Care members were, on average, significantly more likely than FFS members to use or need: 
o	Medical equipment or supplies – 43% vs. 31%
o	Help with personal care or to do everyday tasks – 37% vs. 26%
o	Help doing things in the community – 31% vs. 28%
o	Day programs services – 11% vs. 8%
o	Assistive technology – 8% vs. 7%
o	Transportation to medical services – 47% vs. 37%
o	Transportation to community activities – 35% vs. 29%
•	No significant changes over the five survey years in either One Care or FFS programs.
Slide 23: Use of or Need for Day Programs
•	There was a statistically significant difference in the use of and need for day programs over the survey years
o	The need for and use of day programs started to decrease in 2019 and dropped sharply in 2021
o	However, the use of or need for this service started to increase in 2022

Note: The following data is shown in bar graphs on this slide.

2018
One Care	14%
FSS	10%

2019
One Care	12%
FSS	9%

2020
One Care	11%
FSS	8%

2021
One Care	8%
FSS	6%

2022
One Care	10%
FSS	7%
Slide 24: Use of or Need for Transportation to Medical Appointments
•	There was a statistically significant difference between One Care and the FFS program in members’ use of and needs for transportation to medical appointments
•	There was also a statistically significant difference across the survey years for use of or need for transportation to medical services
•	The need for medical transportation decreased in 2020, the year when COVID-19 PHE was declared, but started to increase in 2021 and 2022

Note: The following data is shown in bar graphs on this slide.

2018
One Care	50%
FSS	40%

2019
One Care	49%
FSS	40%

2020
One Care	43%
FSS	34%

2021
One Care	45%
FSS	36%

2022
One Care	46%
FSS	37%
Slide 25: Use of or Need for Transportation to Community Activities
•	There was a statistically significant difference between One Care and the FFS program in members’ use of and needs for transportation to community activities
•	While there was no statistically significant difference across the survey years for use of or need for transportation to community activities, it is worth noting that the need for and use of those services slightly decreased during the COVID-19 PHE but by 2022 had returned to its 2018 level

Note: The following data is shown in bar graphs on this slide.

2018
One Care	37%
FSS	30%

2019
One Care	35%
FSS	30%

2020
One Care	34%
FSS	26%

2021
One Care	33%
FSS	28%

2022
One Care	37%
FSS	28%
Slide 26: Q2b: Needs Met for Medical, BH, and LTSS
Title slide, no content on this slide.
Slide 27: How Well Needs Were Met for: 
Specialty Care***
There was a statistically significant difference in how well needs for specialty care were met by the program and across years:
•	On average, 81% of One Care members reported their need was very well met compared to 75% of members in the FFS program.
•	There was a 4% decline in the percentage of members who reported their need was well met, from 83% in 2018 to 79% in 2022 for One Care members and from 78% in 2018 to 74% in 2022 for FFS members.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	81%
Somewhat	15%
Not at all	4%

FFS
Very well	75%
Somewhat	20%
Not at all	5%

One Care

2018
Very well	83%
Somewhat	13%
Not at all	4%

2019
Very well	81%
Somewhat	14%
Not at all	5%

2020
Very well	80%
Somewhat	15%
Not at all	5%

2021
Very well	80%
Somewhat	16%
Not at all	4%

2022
Very well	79%
Somewhat	16%
Not at all	5%
FFS
2018
Very well	78%
Somewhat	18%
Not at all	4%

2019
Very well	76%
Somewhat	19%
Not at all	5%

2020
Very well	75%
Somewhat	20%
Not at all	5%

2021
Very well	74%
Somewhat	21%
Not at all	4%

2022
Very well	74%
Somewhat	21%
Not at all	5%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 28: How Well Needs Were Met for:
Physical, Occupational, or Speech Therapy***
There were statistically significant differences in how well needs for physical, occupational, or speech therapy services were met by the program and across years:
•	On average, 66% of One Care members reported their need was very well met compared to 54% of members in the FFS program.
•	There was a 5% decline in the percentage of One Care members who reported their need was well met, from 69% in 2018 to 67% in 2022, and a 6% decline for FFS members from 57% in 2018 to 51% in 2022.

Note: The following data is shown in bar graphs on this slide.

Average by Program

One Care
Very well	66%
Somewhat	23%
Not at all	11%

FFS
Very well	54%
Somewhat	27%
Not at all	19%
One Care
2018
Very well	69%
Somewhat	23%
Not at all	8%

2019
Very well	65%
Somewhat	22%
Not at all	14%

2020
Very well	67%
Somewhat	22%
Not at all	11%

2021
Very well	67%
Somewhat	24%
Not at all	9%

2022
Very well	64%
Somewhat	23%
Not at all	13%
FFS
2018
Very well	57%
Somewhat	28%
Not at all	14%

2019
Very well	51%
Somewhat	25%
Not at all	23%

2020
Very well	54%
Somewhat	26%
Not at all	19%

2021
Very well	55%
Somewhat	29%
Not at all	16%

2022
Very well	51%
Somewhat	27%
Not at all	22%

* Denotes significance level of <0.05, ** significance level  of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 29: How Well Needs Were Met for:
Oral Health or Dental Care***
There were statistically significant differences in how well needs for oral health or dental care were met by program and across years:
•	On average, 66% of One Care members reported their need was very well met compared to 49% of members in the FFS program.
•	There was a 5% decline in the percentage of One Care members who reported their need was well met, from 70% in 2018 to 65% in 2022, and a 7% decline for FFS members from 55% in 2018 to 48% in 2022.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	66%
Somewhat	24%
Not at all	11%

FFS
Very well	49%
Somewhat	28%
Not at all	22%
One Care
2018
Very well	70%
Somewhat	21%
Not at all	8%

2019
Very well	68%
Somewhat	23%
Not at all	8%

2020
Very well	62%
Somewhat	26%
Not at all	12%

2021
Very well	63%
Somewhat	24%
Not at all	13%

2022
Very well	65%
Somewhat	24%
Not at all	11%
FFS
2018
Very well	55%
Somewhat	27%
Not at all	18%

2019
Very well	53%
Somewhat	29%
Not at all	18%

2020
Very well	45%
Somewhat	31%
Not at all	24%

2021
Very well	46%
Somewhat	28%
Not at all	26%

2022
Very well	48%
Somewhat	28%
Not at all	24%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 30: How Well Needs Were Met for:
Prescription Medications***
There was a statistically significant difference in how well needs for prescription medications were met by the program but not across years:
•	On average, 90% of One Care members reported their need was very well met compared to 84% of members in the FFS program.
•	There was a 2% decline in the percentage of One Care members who reported their need was well met, from 91% in 2018 to 89% in 2022, and from 85% in 2018 to 83% in 2022 for FFS members. 

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	90%
Somewhat	9%
Not at all	1%

FFS
Very well	84%
Somewhat	14%
Not at all	1%
One Care
2018
Very well	91%
Somewhat	8%
Not at all	2%

2019
Very well	90%
Somewhat	8%
Not at all	2%

2020
Very well	90%
Somewhat	9%
Not at all	1%

2021
Very well	90%
Somewhat	8%
Not at all	2%

2022
Very well	89%
Somewhat	10%
Not at all	1%
FFS
2018
Very well	85%
Somewhat	13%
Not at all	2%

2019
Very well	84%
Somewhat	14%
Not at all	2%

2020
Very well	84%
Somewhat	15%
Not at all	1%

2021
Very well	84%
Somewhat	14%
Not at all	2%

2022
Very well	83%
Somewhat	16%
Not at all	1%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant

Slide 31: How Well Needs Were Met for:
Mental Health Services***
There were statistically significant differences in how well needs for mental health services were met by the program and across years:
•	On average, 78% of One Care members reported their need was very well met compared to 69% of members in the FFS program.
•	There was a 5% decline in the percentage of One Care members who reported their need was well met, from 80% in 2018 to 75% in 2022, and a 7% decline for FFS members from 72% in 2018 to 65% in 2022.

Note: The following data is shown in bar graphs on this slide.

Average by Program
One Care
Very well	78%
Somewhat	15%
Not at all	6%

FFS
Very well	69%
Somewhat	21%
Not at all	10%
One Care
2018
Very well	80%
Somewhat	16%
Not at all	4%

2019
Very well	80%
Somewhat	15%
Not at all	5%

2020
Very well	78%
Somewhat	15%
Not at all	6%

2021
Very well	78%
Somewhat	16%
Not at all	6%

2022
Very well	75%
Somewhat	15%
Not at all	9%
FFS
2018
Very well	72%
Somewhat	22%
Not at all	7%

2019
Very well	71%
Somewhat	21%
Not at all	8%

2020
Very well	69%
Somewhat	21%
Not at all	10%

2021
Very well	68%
Somewhat	22%
Not at all	10%

2022
Very well	65%
Somewhat	21%
Not at all	14%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 32: How Well Needs Were Met for:
Substance Use Treatment*
There was no statistically significant difference in how well needs for substance use treatment were met by the program but there was a statistically significant difference in how well those needs were met across years:
•	On average, 73% of One Care members reported their need was very well met compared to 71% of members in the FFS program.
•	There was an increase in the percentage of One Care members who reported their need was well met in 2020 and 2021, which declined in 2022 to a level lower than the 2018 percentage, a similar pattern was seen for the FFS program, suggesting external factors impacted access to this service.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	73%
Somewhat	15%
Not at all	12%

FFS
Very well	71%
Somewhat	19%
Not at all	10%
One Care
2018
Very well	67%
Somewhat	20%
Not at all	13%

2019
Very well	69%
Somewhat	20%
Not at all	11%

2020
Very well	82%
Somewhat	11%
Not at all	7%

2021
Very well	78%
Somewhat	7%
Not at all	15%

2022
Very well	63%
Somewhat	23%
Not at all	14%
FFS
2018
Very well	64%
Somewhat	25%
Not at all	11%

2019
Very well	66%
Somewhat	24%
Not at all	9%

2020
Very well	80%
Somewhat	14%
Not at all	6%

2021
Very well	78%
Somewhat	9%
Not at all	14%

2022
Very well	60%
Somewhat	28%
Not at all	12%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 33: How Well Needs Were Met for:
Transportation to Medical Appointments***
There was a statistically significant difference in how well needs for transportation to medical appointments were met by the program and across years:
•	On average, 73% of One Care members reported their need was very well met compared to 58% of members in the FFS program.
•	There was a 4% increase in the percentage of One Care members who reported their need was well met, from 70% in 2018 to 74% in 2022, and a 5% increase for FFS members from 55% in 2018 to 60% in 2022.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	73%
Somewhat	19%
Not at all	8%

FFS
Very well	58%
Somewhat	24%
Not at all	17%
One Care
2018
Very well	70%
Somewhat	19%
Not at all	10%

2019
Very well	72%
Somewhat	19%
Not at all	8%

2020
Very well	75%
Somewhat	17%
Not at all	8%

2021
Very well	71%
Somewhat	20%
Not at all	9%

2022
Very well	74%
Somewhat	19%
Not at all	7%
FFS
2018
Very well	55%
Somewhat	25%
Not at all	20%

2019
Very well	58%
Somewhat	25%
Not at all	17%

2020
Very well	61%
Somewhat	23%
Not at all	16%

2021
Very well	57%
Somewhat	25%
Not at all	18%

2022
Very well	60%
Somewhat	25%
Not at all	15%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 34: How Well Needs Were Met for:
Transportation to Community Activities***
There was a statistically significant difference in how well needs for transportation to community activities was met by the program and across years:
•	On average, 61% of One Care members reported their need was very well met compared to 50% of members in the FFS program.
•	There was a 5% increase in the percentage of One Care members who reported their need was well met, from 59% in 2018 to 64% in 2022, and a similar increase for FFS members: from 48% in 2018 to 63% in 2022.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	61%
Somewhat	23%
Not at all	16%

FFS
Very well	50%
Somewhat	28%
Not at all	22%
One Care
2018
Very well	59%
Somewhat	22%
Not at all	19%

2019
Very well	61%
Somewhat	24%
Not at all	15%

2020
Very well	59%
Somewhat	22%
Not at all	18%

2021
Very well	61%
Somewhat	24%
Not at all	15%

2022
Very well	64%
Somewhat	22%
Not at all	14%
FFS
2018
Very well	48%
Somewhat	27%
Not at all	25%

2019
Very well	50%
Somewhat	30%
Not at all	20%

2020
Very well	48%
Somewhat	27%
Not at all	24%

2021
Very well	50%
Somewhat	30%
Not at all	20%

2022
Very well	53%
Somewhat	27%
Not at all	19%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 35: How Well Needs Were Met for:
Help with Personal Care and Everyday Tasks**

There was a statistically significant difference in how well needs for help with personal care and everyday tasks was met by the program but not across years:
•	On average, 66% of One Care members reported their need was very well met compared to 55% of members in the FFS program.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	66%
Somewhat	20%
Not at all	14%

FFS
Very well	55%
Somewhat	28%
Not at all	17%
One Care
2018
Very well	66%
Somewhat	20%
Not at all	14%

2019
Very well	64%
Somewhat	21%
Not at all	15%

2020
Very well	65%
Somewhat	20%
Not at all	14%

2021
Very well	67%
Somewhat	19%
Not at all	14%

2022
Very well	66%
Somewhat	20%
Not at all	14%
FFS
2018
Very well	56%
Somewhat	28%
Not at all	16%

2019
Very well	53%
Somewhat	29%
Not at all	17%

2020
Very well	54%
Somewhat	29%
Not at all	17%

2021
Very well	56%
Somewhat	27%
Not at all	17%

2022
Very well	56%
Somewhat	28%
Not at all	16%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 36: How Well Needs Were Met for:
Help Doing Things in The Community**
There was a statistically significant difference in how well the needs for help doing things in the community was met by the program but not across years:
•	On average, 46% of One Care members reported their need was very well met compared to 43% of members in the FFS program.
•	There was a 2% increase in the percentage of One Care members who reported their need was well met, from 46% in 2018 to 48% in 2022, and a similar increase for FFS members from 43% in 2018 to 45% in 2022. 

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	46%
Somewhat	25%
Not at all	28%

FFS
Very well	43%
Somewhat	33%
Not at all	24%
One Care
2018
Very well	46%
Somewhat	25%
Not at all	29%

2019
Very well	48%
Somewhat	25%
Not at all	27%

2020
Very well	45%
Somewhat	25%
Not at all	30%

2021
Very well	45%
Somewhat	26%
Not at all	29%

2022
Very well	48%
Somewhat	26%
Not at all	26%
FFS
2018
Very well	43%
Somewhat	32%
Not at all	25%

2019
Very well	45%
Somewhat	33%
Not at all	23%

2020
Very well	42%
Somewhat	32%
Not at all	26%

2021
Very well	42%
Somewhat	34%
Not at all	25%

2022
Very well	45%
Somewhat	33%
Not at all	22%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 37: How Well Needs Were Met for:
Day Program ServicesNS

There were no statistical differences in how well needs for day program services were met by the program or across years:
•	On average, 56% of One Care members reported their need was very well met compared to 54% of members in the FFS program.
•	There was a 4% decline in the percentage of One Care members who reported their need was well met, from 61% in 2018 to 57% in 2022, and by 3% for FFS members from 58% in 2018 to 55% in 2022.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	56%
Somewhat	19%
Not at all	26%

FFS
Very well	54%
Somewhat	21%
Not at all	25%
One Care
2018
Very well	61%
Somewhat	19%
Not at all	21%

2019
Very well	57%
Somewhat	18%
Not at all	25%

2020
Very well	50%
Somewhat	22%
Not at all	28%

2021
Very well	53%
Somewhat	15%
Not at all	32%

2022
Very well	57%
Somewhat	18%
Not at all	25%
FFS
2018
Very well	58%
Somewhat	21%
Not at all	20%

2019
Very well	55%
Somewhat	20%
Not at all	25%

2020
Very well	48%
Somewhat	25%
Not at all	27%

2021
Very well	52%
Somewhat	17%
Not at all	31%

2022
Very well	55%
Somewhat	21%
Not at all	24%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant

Slide 38: How Well Needs Were Met for:
Medical Equipment and Supplies***
There were statistically significant differences in how well needs for medical equipment and supplies were met by the program and across years:
•	On average, 74% of One Care members reported their need was very well met compared to 64% of members in the FFS program.
•	There was a 6% decline in the percentage of One Care members who reported their need was well met, from 77% in 2018 to 71% in 2022, and an 8% decrease for FFS members: from 67% in 2018 to 59% in 2022.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	74%
Somewhat	18%
Not at all	7%

FFS
Very well	64%
Somewhat	26%
Not at all	10%
One Care
2018
Very well	77%
Somewhat	16%
Not at all	7%

2019
Very well	74%
Somewhat	18%
Not at all	8%

2020
Very well	76%
Somewhat	18%
Not at all	6%

2021
Very well	74%
Somewhat	19%
Not at all	7%

2022
Very well	71%
Somewhat	21%
Not at all	8%
FFS
2018
Very well	67%
Somewhat	23%
Not at all	10%

2019
Very well	63%
Somewhat	25%
Not at all	12%

2020
Very well	65%
Somewhat	26%
Not at all	9%

2021
Very well	63%
Somewhat	27%
Not at all	10%

2022
Very well	59%
Somewhat	30%
Not at all	11%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 39: How Well Needs Were Met for:
Assistive Technology*
There was a statistically significant difference in how well needs for assistive technology was met by the program but not across years:
•	On average, 36% of One Care members reported their need was very well met compared to 29% of members in the FFS program.
•	There was a 16% decline in the percentage of One Care members who reported their need was well met, from 46% in 2018 to 30% in 2022, and by 15% for FFS members from 38% in 2018 to 23% in 2022.

Note: The following data is shown in bar graphs on this slide.
Average by Program
One Care
Very well	36%
Somewhat	19%
Not at all	46%

FFS
Very well	29%
Somewhat	27%
Not at all	44%
One Care
2018
Very well	46%
Somewhat	14%
Not at all	40%

2019
Very well	30%
Somewhat	22%
Not at all	48%

2020
Very well	38%
Somewhat	15%
Not at all	48%

2021
Very well	37%
Somewhat	19%
Not at all	45%

2022
Very well	30%
Somewhat	24%
Not at all	46%
FFS
2018
Very well	38%
Somewhat	22%
Not at all	40%

2019
Very well	23%
Somewhat	31%
Not at all	46%

2020
Very well	31%
Somewhat	22%
Not at all	47%

2021
Very well	30%
Somewhat	27%
Not at all	44%

2022
Very well	23%
Somewhat	33%
Not at all	44%

* Denotes significance level of <0.05, ** significance level of <0.001, *** significance level of <0.0001, and NS denotes not statistically significant
Slide 40: Percentage of Members Needs Well Met:
Medical, BH, LTSS and Transportation Needs
•	Between 2018 and 2022, an average One Care member had 4.98 medical, BH, LTSS, and transportation needs compared to 4.39 needs for an average member enrolled in the FFS program.
•	On average, 87% of these needs were well or somewhat met for One Care compared to 86% for FFS members, the difference was statistically significant. 

Note: the following data is shown in bar graphs on this slide.

The number of needs for medical, BH, LTSS, and transportation services for an average One Care member and the number of those needs met

Transportation Services (84%)
	Needs very well or somewhat met	0.61
	Needs 	0.73

LTSS Services (78%)
	Needs very well or somewhat met	0.91
	Needs 	1.16

BH services (90%)
	Needs very well or somewhat met	0.49
	Needs 	0.55

Medical Services (91%)
	Needs very well or somewhat met	2.31
	Needs 	2.54

All Need (87%)
	Needs very well or somewhat met	4.32
	Needs 	4.98

The number of needs for medical, BH, LTSS, and transportation services for an average FFS member and the number of those needs met

Transportation Services (79%)
	Needs very well or somewhat met	0.48
	Needs 	0.60

LTSS Services (79%)
	Needs very well or somewhat met	0.72
	Needs 	0.91

BH services (89%)
	Needs very well or somewhat met	0.42
	Needs 	0.48

Medical Services (89%)
	Needs very well or somewhat met	2.15
	Needs 	2.41

All Need (86%)
	Needs very well or somewhat met	3.76
	Needs 	4.39

Note: Medical services include Specialty care, physical occupational or speech therapy, oral health or dental care, and prescription medications, BH services included mental health services, substance use treatment, LTS services include help with personal care or everyday task, medical equipment and supplies, assistive technology, doing things in the community, and day program services. Transportation services include transportation to medical appointments and transportation to community activities. 
Slide 41: Q3: What impact does experience with care coordination have on the number of self-reported needs met for medical, BH, LTSS, and Transportation services for members enrolled in One Care?
Title slide, no content on this slide.
Slide 42: Impact of Care Coordination
•	For this analysis, we focused on members who reported they had a care coordinator whom they had met within the last 12 months and members who reported they don’t have a care coordinator.
•	Members who met with their Care Coordinator in the last 12 months had 12% more of their medical, BH, LTSS, and transportation needs met (88%) compared to One Care members who reported they don’t have a care coordinator (76%).
o	Members who met with their Care Coordinator in the last 12 months had 11% more of their medical needs met (93%) compared to One Care members who reported not having a care coordinator (82%).
o	Members who met with their Care Coordinator in the last 12 months had 11% more of their BH needs met (92%) compared to One Care members who reported not having a care coordinator (81%).
o	Members who met with their Care Coordinator in the last 12 months had 20% more of their LTSS needs met (83%) compared to One Care members who reported not having a care coordinator (63%).
o	Members who met with their Care Coordinator in the last 12 months had 15% more of their transportation needs met (87%) compared to One Care members who reported not having a care coordinator (72%).
•	The impact of the care coordinator was significant in assisting members get their needs met, especially for LTSS and transportation. 
•	All of these differences were statistically significant at p<0.001.
Slide 43: Q4: Impact of One Care Program’s Actions during the COVID-19 PHE on One Care Members Reporting their Needs were Well Met
Title slide, no content on this slide.
Slide 44: COVID-19 Impact on Services

•	There was a positive and statistically significant effect associated with One Care program action during the COVID-19 PHE, where more One Care members (6%) reported their needs for oral health and dental care were well met (64%) compared to what would have been expected (58%).
•	There was a negative and statistically significant effect associated with One Care program action during the COVID-19 PHE, where fewer One Care members (-7%) reported their needs for medical equipment and supplies were well met (71%) compared to what would have been expected (78%).

Note: The following data is shown in line graphs on this slide.
Oral Health
FFS
2018-2019	55%
2020-2022	46%

One Care
2018-2019	67%
2020-2022	64%
Expected change	54%
Medical Equipment and Supplies
FFS
2018-2019	63%
2020-2022	65%

One Care
2018-2019	76%
2020-2022	71%
Expected change	78%
Slide 45: Conclusions, and Policy Recommendations
Title slide, no content on this slide.
Slide 46: Policy Recommendations
•	To improve communication with members regarding the role of care coordinator and LTS-C, use multiple modalities (e.g., telephone, text, and email).  
•	To ensure improved access to care coordinators and providers, continue policies expandingbut not requiringaccess to virtual options.
•	To address low uptake of LTS-C services, ensure that these services are offered to members with significant BH needs.
•	To improve access to substance use services, continue or reinstate pandemic-era policies supporting flexible access.
•	To improve members' understanding of the importance of the ICP in getting their personal health care goals met, use multiple modalities (e.g., telephone, text, and email) to communicate regarding the original content of the plan and any changes needed to the ICP. 
•	To increase the One Care program's ability to meet members' needs for durable medical equipment and supplies, implement policies to address the shortage of durable medical equipment vendors.
•	To increase the One Care program's ability to meet members' needs for assistive technology (AT) and dual-use AT, increase care coordinator and provider training on the uses and benefits of AT.
Slide 47: Research Team

Yara Halasa-Rappel, PhD, DMD
Research & Evaluation
yara.halasa@umassmed.edu 
781-330-9015

Linda Long-Bellil, PhD, JD
Research & Evaluation
linda.long@umassmed.edu
508-856-8417

Jianying Zhang, MPH, MD
Research & Evaluation
Jianying.Zhang@umassmed.edu
Slide 48: Methodology
Title slide, no content on this slide.
Slide 49: Survey Implementation
•	Survey administered annually between January and May
•	Survey administered in English and Spanish 
•	Implementation:
o	Two-wave mail survey
o	Five telephone follow-ups

Note: The following data is shown in a two-columned table on this slide.

MES Survey (Reference Year)	2018
Data collection (Year) 	2019

MES Survey (Reference Year)	2019
Data collection (Year) 	2020

MES Survey (Reference Year)	2020
Data collection (Year) 	2021

MES Survey (Reference Year)	2021
Data collection (Year) 	2022

MES Survey (Reference Year)	2022
Data collection (Year) 	2023
Slide 50: Methods: Sampling
Note: the following information is shown in three columns on this slide. This is noted here in case the presenter refers to the columns.
Sample Frame
•	Received MassHealth enrollment files
•	Identified members enrolled as of December of the survey measurement year for 90+ days
•	Selected four random samples based on members’ enrollment in One Care plans (Tufts, CCA, UnitedHealth) and FFS 
•	Each sample was given a weight value representing the number of enrollees in each health plan  
Exclusion criteria
(sampling)
•	Members selected for the Quality of Life Survey in the survey measurement year
•	Members enrolled for less than 90 days
•	Invalid contact information (e.g., phone number)
•	Reside outside MA
•	Reported primary language other than English or Spanish*
Ineligibility criteria
(survey implementation)
•	Unable to complete the survey due to: 
o	Physical and mental incapacity
o	Communication barriers 
o	Deceased

* Due to restrictions in survey administration. However, most of the members have English as their primary language by default, regardless of the actual primary language spoken at home 
Slide 51: Methods: Respondents’ Characteristics
•	One Care and FFS data from 2018 through 2022 were combined. 
•	To generalize the findings, the results were adjusted using two weights: (1) non-response, and (2) the study sample to population weight.
•	Respondents’ characteristics were different over the five survey years. To be able to compare the results over time, we controlled for these characteristics using ordered or multinomial regression analyses.
•	The predicted values from those regressions were used to answer the four research questions.
Slide 52: Methods: Analyses
Q1: Experience with Care Team

•	Used multinomial/logistic regressions to control for changes in members’ characteristics, reported disabilities, and residence
•	Compared members’ healthcare experience among those enrolled in One Care to those enrolled in the FFS program using multinomial/ordered logistic regression models controlling for members’ characteristics, reported disabilities, and residence
•	Findings were reported as statistically significant, i.e., not explained simply by chance based on a p-value of ≤.05
Slide 53: Methods: Analyses
Q2: Medical, BH, LTSS, and Transportation Needs
•	Descriptive analysis of the use/needs of medical, BH, and LTSS services, and how well those needs were met
o	Tested for change in members’ needs and their perception of how well their needs were met between 2018 and 2022 using logistic and multinomial logistic regressions to control for the change in members’ characteristics over time 
o	Estimated the percentage of reported needs for medical, BH, and LTSS services and the percentage of medical, BH, and LTSS needs that were well met or somewhat met by One Care and FFS plans
•	Since a member might have more than one need, we estimated the average numbers of medical and BH services and LTSS the member used/needed and constructed a “needs met” index to compute the percentage of all reported medical, BH, and LTSS needs that were well or somewhat met 
Slide 54: Methods: Analyses
Q3: Impact of Care Coordination
•	Generated a dummy variable to identify:
o	One Care members who reported they have a care coordinator whom they met in the last 12 months
o	One Care members who reported not having a care coordinator 
•	Used Ordinary Least Squares (OLS) regressions to estimate the impact of meeting with a care coordinator in the last 12 months by estimating the number of needs and the number and percentage of needs well or somewhat met for:
o	Any medical, BH, LTSS, or transportation services
o	Any medical services
o	Any BH services
o	Any LTSS services
o	Any transportation services
Slide 55: Methods: Analyses
Q4: Impact of One Care Program Actions during the COVID-19 PHE
•	Used ordered logistic regression to derive the difference-in-differences estimates associated with how well One Care met members’ needs for medical and BH services and LTSS, controlling for members’ characteristics:
o	Responses to surveys conducted in 2018-2019 (n=5,494) were designated as pre-COVID, and responses to surveys conducted in 2020-2022 (n=6,899), were designated as having occurred during the COVID-19 PHE
Slide 56: Demographics

•	Between 2018 and 2022, the One Care survey respondents had different demographics and residency except for:
o	Gender
•	Between 2018 and 2022, the FFS respondents had different demographics and residency except for:
o	Race/Ethnicity
•	One Care and FFS respondents were significantly different when it comes to their demographics and residency

Note: The following data is shown in a table on this slide.

Notes: 
Results presented at the population level.
NS denotes not statistically significant
* P-value<0.05
** P value <0.01
*** P-value <0.001
One Care
2018
# of Respondents	1,498
# of weighted respondents/population	5,368

Age group		***
21 to 34	4%
35 to 44	10%
45 to 54	22%
55 to 64	57%
65+	7%
Gender		NS
Male	43%
Female	57%
Others	0%
Education		*
Some high school or less	18%
high school graduate or GED	62%
4-year college or more	12%
Missing	8%
Primary Language		**
English	76%
Spanish	13%
Others	2%
Missing	9%
Race/Ethnicity		*
White (non-Hispanic)	56%
Hispanic or Latino	23%
Black (non-Hispanic)	12%
Others	6%
Missing 	2%
Region of residency		***
Western Region	26%
Central Region	17%
Northeast Region	20%
Metro West Region	14%
Southeast Region	6%
Boston Region	17%

2019
# of Respondents	1,641
# of weighted respondents/population	6,219
Age group
21 to 34	3%
35 to 44	6%
45 to 54	24%
55 to 64	61%
65+	6%
Gender
Male	43%
Female	57%
Others	0%
Education
Some high school or less	20%
high school graduate or GED	60%
4-year college or more	11%
Missing	9%
Primary Language
English	72%
Spanish	17%
Others	2%
Missing	9%
Race/Ethnicity
White (non-Hispanic)	54%
Hispanic or Latino	25%
Black (non-Hispanic)	12%
Others	6%
Missing 	3%
Region of residency
Western Region	27%
Central Region	15%
Northeast Region	21%
Metro West Region	14%
Southeast Region	6%
Boston Region	17%

2020
# of Respondents	1,403
# of weighted respondents/population	6,009
Age group
21 to 34	3%
35 to 44	9%
45 to 54	21%
55 to 64	59%
65+	9%
Gender
Male	38%
Female	61%
Others	0%
Education
Some high school or less	19%
high school graduate or GED	61%
4-year college or more	9%
Missing	11%
Primary Language
English	72%
Spanish	15%
Others	3%
Missing	10%
Race/Ethnicity
White (non-Hispanic)	55%
Hispanic or Latino	25%
Black (non-Hispanic)	12%
Others	5%
Missing 	3%
Region of residency
Western Region	30%
Central Region	16%
Northeast Region	19%
Metro West Region	13%
Southeast Region	8%
Boston Region	14%

2021
# of Respondents	1,255
# of weighted respondents/population	5,845
Age group
21 to 34	3%
35 to 44	8%
45 to 54	21%
55 to 64	56%
65+	11%
Gender
Male	41%
Female	58%
Others	0%
Education
Some high school or less	17%
high school graduate or GED	61%
4-year college or more	12%
Missing	10%
Primary Language
English	77%
Spanish	12%
Others	2%
Missing	9%
Race/Ethnicity
White (non-Hispanic)	58%
Hispanic or Latino	20%
Black (non-Hispanic)	12%
Others	6%
Missing 	4%
Region of residency
Western Region	29%
Central Region	15%
Northeast Region	18%
Metro West Region	12%
Southeast Region	11%
Boston Region	14%

2022
# of Respondents	1,232
# of weighted respondents/population	6,971
Age group
21 to 34	3%
35 to 44	9%
45 to 54	18%
55 to 64	55%
65+	16%
Gender
Male	38%
Female	61%
Others	0%
Education
Some high school or less	18%
high school graduate or GED	60%
4-year college or more	10%
Missing	12%
Primary Language
English	76%
Spanish	10%
Others	2%
Missing	11%
Race/Ethnicity
White (non-Hispanic)	57%
Hispanic or Latino	21%
Black (non-Hispanic)	11%
Others	7%
Missing 	4%
Region of residency
Western Region	24%
Central Region	15%
Northeast Region	19%
Metro West Region	15%
Southeast Region	15%
Boston Region	13%
FFS
2018
# of Respondents	1,145
# of weighted respondents/population	14,638
Age group		***
21 to 34	4%
35 to 44	8%
45 to 54	25%
55 to 64	63%
65+	1%
Gender		*
Male	44%
Female	55%
Others	0%
Education		**
Some high school or less	19%
high school graduate or GED	64%
4-year college or more	10%
Missing	7%
Primary Language		*
English	84%
Spanish	6%
Others	2%
Missing	7%
Race/Ethnicity		NS
White (non-Hispanic)	74%
Hispanic or Latino	11%
Black (non-Hispanic)	5%
Others	7%
Missing 	2%
Region of residency		***
Western Region	25%
Central Region	9%
Northeast Region	15%
Metro West Region	9%
Southeast Region	36%
Boston Region	6%

2019
# of Respondents	1,1210
# of weighted respondents/population	13,934
Age group		***
21 to 34	4%
35 to 44	9%
45 to 54	20%
55 to 64	66%
65+	0%
Gender		*
Male	41%
Female	58%
Others	0%
Education		**
Some high school or less	14%
high school graduate or GED	66%
4-year college or more	12%
Missing	8%
Primary Language		*
English	82%
Spanish	7%
Others	3%
Missing	8%
Race/Ethnicity		NS
White (non-Hispanic)	73%
Hispanic or Latino	11%
Black (non-Hispanic)	5%
Others	8%
Missing 	3%
Region of residency		***
Western Region	29%
Central Region	9%
Northeast Region	13%
Metro West Region	9%
Southeast Region	32%
Boston Region	7%

2020
# of Respondents	1,078
# of weighted respondents/population	18,454
Age group		***
21 to 34	5%
35 to 44	7%
45 to 54	18%
55 to 64	56%
65+	15%
Gender		*
Male	43%
Female	56%
Others	1%
Education		**
Some high school or less	14%
high school graduate or GED	67%
4-year college or more	13%
Missing	6%
Primary Language		*
English	83%
Spanish	6%
Others	2%
Missing	8%
Race/Ethnicity		NS
White (non-Hispanic)	75%
Hispanic or Latino	11%
Black (non-Hispanic)	4%
Others	6%
Missing 	3%
Region of residency		***
Western Region	40%
Central Region	9%
Northeast Region	13%
Metro West Region	10%
Southeast Region	23%
Boston Region	6%

2021
# of Respondents	975
# of weighted respondents/population	16,830
Age group		***
21 to 34	4%
35 to 44	8%
45 to 54	16%
55 to 64	51%
65+	22%
Gender		*
Male	42%
Female	57%
Others	0%
Education		**
Some high school or less	13%
high school graduate or GED	67%
4-year college or more	14%
Missing	6%
Primary Language		*
English	86%
Spanish	6%
Others	2%
Missing	7%
Race/Ethnicity		NS
White (non-Hispanic)	75%
Hispanic or Latino	10%
Black (non-Hispanic)	7%
Others	6%
Missing 	3%
Region of residency		***
Western Region	41%
Central Region	8%
Northeast Region	12%
Metro West Region	10%
Southeast Region	24%
Boston Region	5%

2022
# of Respondents	956
# of weighted respondents/population	16,078
Age group		***
21 to 34	3%
35 to 44	6%
45 to 54	14%
55 to 64	42%
65+	34%
Gender		*
Male	46%
Female	53%
Others	0%
Education		**
Some high school or less	14%
high school graduate or GED	64%
4-year college or more	13%
Missing	10%
Primary Language		*
English	81%
Spanish	5%
Others	3%
Missing	11%
Race/Ethnicity		NS
White (non-Hispanic)	72%
Hispanic or Latino	10%
Black (non-Hispanic)	6%
Others	7%
Missing 	4%
Region of residency		***
Western Region	26%
Central Region	12%
Northeast Region	16%
Metro West Region	12%
Southeast Region	26%
Boston Region	8%
Difference between One Care and FFS
FFS
# of Respondents	5,364
Age group		***
21 to 34	4%
35 to 44	7%
45 to 54	18%
55 to 64	55%
65+	15%
Gender		**
Male	44%
Female	56%
Others	0%
Education		***
Some high school or less	15%
high school graduate or GED	66%
4-year college or more	12%
Missing	7%
Primary Language		***
English	83%
Spanish	6%
Others	2%
Missing	8%
Race/Ethnicity		***
White (non-Hispanic)	74%
Hispanic or Latino	11%
Black (non-Hispanic)	6%
Others	7%
Missing 	3%
Region of residency		***
Western Region	33%
Central Region	9%
Northeast Region	14%
Metro West Region	10%
Southeast Region	28%
Boston Region	7%
One Care
# of Respondents	7,029
Age group		***
21 to 34	3%
35 to 44	8%
45 to 54	21%
55 to 64	58%
65+	10%
Gender		**
Male	41%
Female	59%
Others	0%
Education		***
Some high school or less	18%
high school graduate or GED	61%
4-year college or more	11%
Missing	10%
Primary Language		***
English	75%
Spanish	14%
Others	2%
Missing	10%
Race/Ethnicity		***
White (non-Hispanic)	56%
Hispanic or Latino	23%
Black (non-Hispanic)	12%
Others	6%
Missing 	3%
Region of residency		***
Western Region	27%
Central Region	16%
Northeast Region	19%
Metro West Region	14%
Southeast Region	9%
Boston Region	15%
Slide 57: Respondents’ Reported Disabilities or Health Conditions
•	Between 2018 and 2022, similar percentages of One Care respondents reported specific disabilities and health conditions except for the following conditions:
o	A problem with alcohol or drug use 
o	Long-term illness

•	Between 2018 and 2022, similar percentages of FFS respondents reported similar disabilities and health conditions, except for the following conditions: 
o	Physical disabilities
o	Mental or psychiatric problems
o	Problem with alcohol or drug use
o	Learning disability
o	Reported two or more disabilities

•	Between 2018 and 2022, similar percentages of FFS and One Care respondents reported similar disabilities and health conditions, except for the following conditions: 
o	Mental or psychiatric problems
o	Learning disability
o	Visual impairment or blindness
o	Hearing loss or deafness (higher among FFS members)
o	Reported two or more disabilities

Note: The following data is shown in a table on this slide.
Reported Disabilities and Health Conditions$
One Care
2018
Physical disabilities 	59%	NS
Mental or psychiatric problems	64%	NS
Problems with alcohol or drug abuse	9%	**
Long-term illness 	53%	**
Developmental disability	9%	NS
Learning disability	24%	NS
Visual impairment or blindness	29%	NS
Hearing loss or deafness	15%	NS
Two or more reported disabilities	89%	NS

2019
Physical disabilities 	60%	NS
Mental or psychiatric problems	65%	NS
Problems with alcohol or drug abuse	6%	**
Long-term illness 	56%	**
Developmental disability	10%	NS
Learning disability	24%	NS
Visual impairment or blindness	29%	NS
Hearing loss or deafness	16%	NS
Two or more reported disabilities	90%	NS

2020
Physical disabilities 	60%	NS
Mental or psychiatric problems	65%	NS
Problems with alcohol or drug abuse	8%	**
Long-term illness 	55%	**
Developmental disability	11%	NS
Learning disability	23%	NS
Visual impairment or blindness	28%	NS
Hearing loss or deafness	14%	NS
Two or more reported disabilities	88%	NS

2021
Physical disabilities 	60%	NS
Mental or psychiatric problems	64%	NS
Problems with alcohol or drug abuse	6%	**
Long-term illness 	61%	**
Developmental disability	12%	NS
Learning disability	25%	NS
Visual impairment or blindness	28%	NS
Hearing loss or deafness	15%	NS
Two or more reported disabilities	89%	NS

2022
Physical disabilities 	60%	NS
Mental or psychiatric problems	63%	NS
Problems with alcohol or drug abuse	6%	**
Long-term illness 	53%	**
Developmental disability	11%	NS
Learning disability	24%	NS
Visual impairment or blindness	31%	NS
Hearing loss or deafness	15%	NS
Two or more reported disabilities	86%	NS
FFS
2018
Physical disabilities 	62%	**
Mental or psychiatric problems	60%	**
Problems with alcohol or drug abuse	8%	**
Long-term illness 	53%	NS
Developmental disability	11%	NS
Learning disability	24%	**
Visual impairment or blindness	24%	NS
Hearing loss or deafness	16%	NS
Two or more reported disabilities	92%	***

2019
Physical disabilities 	62%	**
Mental or psychiatric problems	62%	**
Problems with alcohol or drug abuse	8%	**
Long-term illness 	54%	NS
Developmental disability	12%	NS
Learning disability	24%	**
Visual impairment or blindness	28%	NS
Hearing loss or deafness	19%	NS
Two or more reported disabilities	92%	***

2020
Physical disabilities 	59%	**
Mental or psychiatric problems	58%	**
Problems with alcohol or drug abuse	6%	**
Long-term illness 	57%	NS
Developmental disability	12%	NS
Learning disability	23%	**
Visual impairment or blindness	24%	NS
Hearing loss or deafness	17%	NS
Two or more reported disabilities	92%	***

2021
Physical disabilities 	58%	**
Mental or psychiatric problems	60%	**
Problems with alcohol or drug abuse	6%	**
Long-term illness 	55%	NS
Developmental disability	9%	NS
Learning disability	19%	**
Visual impairment or blindness	25%	NS
Hearing loss or deafness	17%	NS
Two or more reported disabilities	91%	***

2022
Physical disabilities 	54%	**
Mental or psychiatric problems	53%	**
Problems with alcohol or drug abuse	4%	**
Long-term illness 	53%	NS
Developmental disability	11%	NS
Learning disability	19%	**
Visual impairment or blindness	22%	NS
Hearing loss or deafness	17%	NS
Two or more reported disabilities	85%	***
Difference between One Care and FFS
FFS
Physical disabilities 	59%	NS
Mental or psychiatric problems	58%	**
Problems with alcohol or drug abuse	6%	NS
Long-term illness 	54%	NS
Developmental disability	11%	NS
Learning disability	22%	**
Visual impairment or blindness	25%	**
Hearing loss or deafness	17%	**
Two or more reported disabilities	90%	**
One Care
Physical disabilities 	60%	NS
Mental or psychiatric problems	64%	**
Problems with alcohol or drug abuse	7%	NS
Long-term illness 	56%	NS
Developmental disability	10%	NS
Learning disability	24%	**
Visual impairment or blindness	29%	**
Hearing loss or deafness	15%	**
Two or more reported disabilities	88%	**

Notes: NS denotes not statistically significant; ** P-value <0.01
$The percentage includes those in the stated disability category only