Slide 1: One Care Implementation Council Meeting
Executive Office of Health & Human Services
MassHealth Demonstration to Integrate Care for Dual Eligibles
June 14, 2022, 10:00 AM – 12:00 PM
Virtual Meeting via Zoom
Slide 2: Agenda
Additional 2018-2021 Voluntary Disenrollment Data
1.	By Rating Category
2.	By Enrollment Length
3.	By County
Slide 3: One Care Voluntary Disenrollment By Rating Category
2018-2021
■	Voluntary disenrollment rates are highest in F1 and lowest in C2 and C3.

Note: the following information is shown in a bar chart on this slide.

% of Average Member in each Rating Category that Voluntarily Disenrolled
2018-2021
•	C1
o	2018=12%
o	2019=11%
o	2020=7%
o	2021=7%
•	C2
o	2018=6%
o	2019=6%
o	2020=4%
o	2021=5%

•	C3
o	2018=6%
o	2019=6%
o	2020=4%
o	2021=6%

•	F1
o	2018=14%
o	2019=21%
o	2020=9%
o	2021=6%

Note:  the following information was shown in a table on this slide.
Average Enrollment by Rating Category
•	C1
o	2018=3,675
o	2019=3,826
o	2020=4,300
o	2021=4,967

•	C2
o	2018=7,260
o	2019=8,309
o	2020=9,470
o	2021=10,334

•	C3
o	2018=9,649
o	2019=11,906
o	2020=14,230
o	2021=16,390

•	F1
o	2018=101
o	2019=166
o	2020=204
o	2021=258

1Members without an available rating category were grouped in C1. C2 includes C2A and C2B; C3 includes C3A and C3B.
2Maintenance of Effort (MOE) protections from the federal Public Health Emergency significantly reduced involuntary disenrollments in 2020 and 2021. Voluntary disenrollment numbers may include some individuals who would have been subject to involuntary disenrollment if enrollments were not protected during these periods.
Slide 4: One Care Voluntary Disenrollment By Rating Category
2018-2021
■	Most voluntary disenrollments come from C3 and C2 despite their lower disenrollment rates, because of their larger enrollment share.

Note: the following information is shown in a bar chart on this slide.
Rating Category Share of Voluntarily Disenrolled
•	C1
o	2018=30%
o	2019=26%
o	2020=25%
o	2021=20%

•	C2
o	2018=30%
o	2019=28%
o	2020=28%
o	2021=27%

•	C3
o	2018=39%
o	2019=44%
o	2020=45%
o	2021=52%

•	F1
o	2018=1%
o	2019=2%
o	2020=2%
o	2021=1%
1Members without an available rating category were grouped in C1. C2 includes C2A and C2B; C3 includes C3A and C3B.
2Maintenance of Effort (MOE) protections from the federal Public Health Emergency significantly reduced involuntary disenrollments in 2020 and 2021. Voluntary disenrollment numbers may include some individuals who would have been subject to involuntary disenrollment if enrollments were not protected during these periods.
Slide 5: One Care Voluntary Disenrollment By Length of Enrollment
■	The voluntary disenrollment rate is much higher in the first six months than after six months of enrollment.

Note: the following information is shown in a bar chart on this slide.
% of Average Members that Voluntarily Disenrolled Before 6 months vs. After 2018-2021
•	Less Than 6 Months
o	2018=22%
o	2019=25%
o	2020=18%
o	2021=25%

•	6+ Months
o	2018=3%
o	2019=3%
o	2020=2%
o	2021=3%

Note:  the following information was shown in a table on this slide.
Average Enrollment by Length of Enrollment
•	Less than 6 Months
o	2018=3,881
o	2019=3,793
o	2020=3,936
o	2021=2,994
•	6+ Months
o	2018=16,803
o	2019=20,414
o	2020=24,268
o	2021=28,955

1Maintenance of Effort (MOE) protections from the federal Public Health Emergency significantly reduced involuntary disenrollments in 2020 and 2021. Voluntary disenrollment numbers may include some individuals who would have been subject to involuntary disenrollment if enrollments were not protected during these periods.
Slide 6: One Care Voluntary Disenrollment By Length of Enrollment 2018-2021
■	The volume of overall voluntary disenrollments comes about evenly from these two groups, due to the much larger number of long-term enrollees.

Note: the following information is shown in a bar chart on this slide.

Share of Members Who Voluntarily Disenrolled Before 6 months vs. After 2018-2021
•	Less Than 6 Months
o	2018=59%
o	2019=58%
o	2020=57%
o	2021=43%

•	6+ Months
o	2018=41%
o	2019=42%
o	2020=43%
o	2021=57%

1Maintenance of Effort (MOE) protections from the federal Public Health Emergency significantly reduced involuntary disenrollments in 2020 and 2021. Voluntary disenrollment numbers may include some individuals who would have been subject to involuntary disenrollment if enrollments were not protected during these periods.
Slide 7: One Care Voluntary Disenrollment By County
2018-2021
■	Voluntary disenrollment rates vary widely across year and county, from 2% to 57%.
% of Average Members that Voluntary Disenrolled by County
County	2018	2019	2020	2021	
Barnstable	N/a	N/a	32%	19%	
Berkshire	N/a	N/a	N/a	38%	
Bristol	17%	57%	23%	20%	
Essex	9%	6%	3%	5%	
Franklin	10%	19%	N/a%	11%	
Hampden	5%	4%	2%	3%	
Hampshire	4%	8%	5%	7%	
Middlesex	8%	6%	4%	5%	
Norfolk	7%	9%	4%	5%	
Plymouth	13%	11%	6%	6%	
Suffolk	5%	7%	3%	4%	
Worcester	7%	6%	6%	5%	

1Maintenance of Effort (MOE) protections from the federal Public Health Emergency significantly reduced involuntary disenrollments in 2020 and 2021. Voluntary disenrollment numbers may include some individuals who would have been subject to involuntary disenrollment if enrollments were not protected during these periods.
Slide 8: One Care Voluntary Disenrollment By County
2018-2021
■	Average voluntary disenrollment rates are highest in Berkshire, Bristol, and Barnstable. These are all low enrollment counties and have all been added to One Care through service area expansions.
% of Each County’s Average Member that Voluntarily Disenrolled 2018-2021 Average
County	Average Member that Voluntarily Disenrolled	
Barnstable	28%	
Berkshire	32%	
Bristol	29%	
Essex	6%	
Franklin	11%	
Hampden	4%	
Hampshire	6%	
Middlesex	6%	
Norfolk	6%	
Plymouth	9%	
Suffolk	5%	
Worcester	6%	

1Maintenance of Effort (MOE) protections from the federal Public Health Emergency significantly reduced involuntary disenrollments in 2020 and 2021. Voluntary disenrollment numbers may include some individuals who would have been subject to involuntary disenrollment if enrollments were not protected during these periods.
Slide 9: One Care Voluntary Enrollment Distribution By County
2018-2021
■	The high average voluntary disenrollment counties have a very low share of statewide enrollment.
Share of Statewide Enrollments by County 2018-2021 Average
Country	% Average	
Barnstable	0%	
Berkshire	0%	
Bristol	1%	
Essex	11%	
Franklin	1%	
Hampden	24%	
Hampshire	1%	
Middlesex	15%	
Norfolk	6%	
Plymouth	5%	
Suffolk	18%	
Worcester	16%	

1Percentages may sum to less than 100% in covered counties as enrollments in non-covered counties are excluded. 
2Maintenance of Effort (MOE) protections from the federal Public Health Emergency significantly reduced involuntary disenrollments in 2020 and 2021. Voluntary disenrollment numbers may include some individuals who would have been subject to involuntary disenrollment if enrollments were not protected during these periods.
Slide 10: One Care Voluntary Disenrollment By County 2018-2021

■	Share of overall statewide voluntary disenrollment is spread more evenly across the state than the rates of voluntary disenrollment by county. 

Share of Statewide Voluntary Disenrollments by County
2018-2021 Average
County	Average %	
Barnstable	2%	
Berkshire	1%	
Bristol	7%	
Essex	11%	
Franklin	2%	
Hampden	15%	
Hampshire	2%	
Middlesex	15%	
Norfolk	6%	
Plymouth	8%	
Suffolk	15%	
Worcester	18%	

1Maintenance of Effort (MOE) protections from the federal Public Health Emergency significantly reduced involuntary disenrollments in 2020 and 2021. Voluntary disenrollment numbers may include some individuals who would have been subject to involuntary disenrollment if enrollments were not protected during these periods.
Slide 11: APPENDIX
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Slide 12: One Care Rating Category Definitions
•	F1 – Facility-based Care
Individuals identified as having a long-term facility stay of more than 90 days 
•	C3 – Community Tier 3 – High LTSS Community Need
Individuals who have a daily skilled need; two or more Activities of Daily Living (ADL) limitations AND three days of skilled nursing need; and individuals with 4 or more ADL limitations - In CY2014, C3 split into two subsets: C3B: for C3 individuals with certain diagnoses (e.g., quadriplegia, ALS, Muscular Dystrophy and Respirator dependence) leading to costs considerably above the average for current C3 C3A: for remaining C3 individuals 
•	C2 – Community Tier 2 – Community High Behavioral Health
Individuals who have a chronic and ongoing Behavioral Health diagnosis that indicates a high level of service need - In CY2014, C2 split into two subsets C2B: for C2 individuals with co-occurring diagnoses of substance abuse and serious mental illness C2A: for remaining C2 individuals 
•	C1 – Community Tier 1 – Community Other
Individuals in the community who do not meet F1, C2 or C3 criteria
Slide 13: One CareMassHealth + Medicare
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