Executive Order  No. 657: Investing in Primary Care in Massachusetts

WHEREAS, primary care is the foundation of a well-functioning health system, and access to primary care is associated with better health outcomes, fewer hospitalizations, and less frequent use of emergency rooms;

WHEREAS, Massachusetts is a global leader in health care, and at a time when health care costs are on the rise and our residents are experiencing persistent challenges in accessing primary care, we must redouble our efforts to ensure that high-quality, affordable primary care is readily available to all state residents;

WHEREAS, research has shown that primary care providers are facing rising rates of burnout, resulting in fewer new health care providers entering primary care and more providers leaving each year;

WHEREAS, expert guidance recommends increased investment in primary care as a means of stabilizing the workforce, attracting new providers into the field, and promoting broad access to high-quality primary care;

WHEREAS, the Healey-Driscoll Administration recognizes that a stronger primary care system in Massachusetts will improve health outcomes and lower costs for residents;

WHEREAS, MassHealth, our state program for Medicaid and the Children’s Health Insurance Program within the Executive Office for Health and Human Services (EOHHS), provides health benefits to 1.9 million Massachusetts residents, including children, families, seniors, and people with disabilities; 

WHEREAS, in 2023, MassHealth launched a new payment model for primary care providers participating in its Accountable Care Organization program, with the goal of providing more consistent revenue for primary care practices and supporting more comprehensive services in the primary care setting;

WHEREAS, through further innovation at MassHealth, the Healey-Driscoll Administration is committed to identifying strategies to increase investments in primary care, thereby improving access for all residents and better supporting the primary care providers who serve our communities;

NOW, THEREFORE, I, Maura T. Healey, Governor of the Commonwealth of Massachusetts, by virtue of the authority vested in me by the Constitution, Part 2, c. 2, § I, Art. I, do hereby order as follows:

SECTION 1. 

Definition of “Total Medical Expenses (TME).”  As used in this Executive Order, TME refers to the full amount paid to providers by EOHHS for non-pharmaceutical, medical and behavioral health care services delivered to the population of members who receive primary care through MassHealth, expressed on a per member per month basis.

SECTION 2. 

EOHHS shall increase its investments in primary care services for MassHealth members who receive primary care through MassHealth, with the goal of spending 12 percent of TME on primary care by December 31, 2028. 

SECTION 3. 

The requirements of Section 2 shall be subject to appropriation, receipt of all necessary federal approvals, and the availability of federal financial participation.

SECTION 4. 

EOHHS shall partner with the Center for Health Information and Analysis to track expenditures subject to this order.

SECTION 5. 

EOHHS shall, at least annually, report to the Governor on the status of its work, until the spending target established in Section 2 is achieved.

SECTION 6. 

This Executive Order shall take effect upon execution and shall continue in effect until amended, superseded, or revoked by subsequent Executive Order.