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Social and Behavioral Sciences Commons

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Full-Text Articles in Social and Behavioral Sciences

Integrating Third Party Liability (Tpl) Across Medicaid Operations And Enterprise Systems In Massachusetts, Jenifer Hartman Aug 2017

Integrating Third Party Liability (Tpl) Across Medicaid Operations And Enterprise Systems In Massachusetts, Jenifer Hartman

Commonwealth Medicine Publications

This poster highlights the results of a UMass Medical School partnership with MassHealth, the Massachusetts Medicaid program, to integrate third party liability (TPL) activities across all aspects of the Medicaid program. By embedding TPL at all stages of Medicaid operations and interfacing with all Medicaid systems, the partners optimized identification of and access to TPL sources for all Medicaid members.

The TPL activities include eligibility coordination, coverage coordination, payment coordination and recovery coordination. The partnership has achieved over $40 million in cost avoidance through the identification of missed Medicare benefits, over $64 million in cost avoidance over enhanced coordination of ...


Determination Of Massachusetts’ Respite Policies And The Potential Impact Of Unpaid Family Care Giver Support On Home And Community Based Services, Leanne Winchester, Kate Russell, Kelly Love Jul 2017

Determination Of Massachusetts’ Respite Policies And The Potential Impact Of Unpaid Family Care Giver Support On Home And Community Based Services, Leanne Winchester, Kate Russell, Kelly Love

Commonwealth Medicine Publications

Direct care workforce shortages, increasing health care costs, and limited access to services force many families to make life-changing decisions to care for family members with long term disabilities or who are chronically ill at home. For this project, the authors conducted an environmental scan of current policies and programs for state and federally funded respite services across Massachusetts’ state agencies.

The results of this project demonstrate the variability in Massachusetts’ state policies and program practices in four primary areas:

  • The types of respite services offered by state agencies

  • The agencies definition of respite services

  • Variability in the ability of ...


Evaluation Of Progesterone Agent Utilization And Birth Outcomes In A State Medicaid Plan, Tasmina Hydery, Mylissa K. Price, Bonnie C. Greenwood, Mito Takeshita, Rose Mauro, Parag Kunte, Kimberly J. Lenz, Paul L. Jeffrey Feb 2017

Evaluation Of Progesterone Agent Utilization And Birth Outcomes In A State Medicaid Plan, Tasmina Hydery, Mylissa K. Price, Bonnie C. Greenwood, Mito Takeshita, Rose Mauro, Parag Kunte, Kimberly J. Lenz, Paul L. Jeffrey

Commonwealth Medicine Publications

An analysis of medication adherence and birth outcomes among members receiving progesterone for the prevention of preterm birth in a state Medicaid program. Data is also used to evaluate the association between member characteristics and medication adherence and birth outcomes as well as whether there was a change in the cost of care.