The MassHealth 2023 ACO program requires all participating PCP sites to attest to a “tier” designation ranging from 1 – 3. Tier designation reflects the level of comprehensive primary care services offered at the practice. In the fall of 2022, each participating PCP practice attested to meeting at least tier 1 by July 1, 2023. Participating primary care practices will be asked to re-attest to a Tier annually.
This page serves as a central repository of resources to help practices meet their tier requirements.
General Resources:
- Overview of MassHealth Primary Care Sub-Capitation Program
- WellSense PC Sub Cap Manual_2.13.24
- ACO Tiering Office Hours Feedback Form
- Tiering FAQs
MassHealth Tiering Tracking Grid:
This updated version of the MH Tiering Tracking grid includes the requests from MassHealth from the 2023 Tiering Audit. We encourage practices to use this as a tool in preparation for the 2024 Tier Audit.
For Tiering Grids in Excel and Word formats please contact [email protected] or [email protected]
Tier 1 Internal Med Tracking Grid
Tier 1 Pediatric Tracking Grid
Tier 1 Family Med Tracking Grid
Moving up a Tier is a cumulative process. To achieve a Tier 2 designation practices must also meet all Tier 1 requirements.
Tier 2:
Tier 2 Family Medicine Tracking Grid
Tier 2 Pediatrics Tracking Grid
Tier 2 Internal Medicine Tracking Grid
Tier 3:
Tier 3 Practices Serving Adult and Pedi – Tiering Tracking Grid
ACO Tiering Office Hours: 4th Thursday of each month
Recordings and Slides:
MH Tiering Office Hours 2.22.24
Epic: OneBILH HRSN Screening
ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_English ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Albanian ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Arabic ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Chinese ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_CV_Creole ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Dari ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_French ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Haitian_creole ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Khmer ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Pashto ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Portuguse ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Russian ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Spanish ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Swahili ONEBILH_BILHPN_Social_Determinants_Questionnaire_SDOH_Vietnamese
Modified PRAPARE:
BILHPN Modified PRAPARE English
BILHPN Modified PRAPARE_Arabic
BILHPN Modified PRAPARE_Chinese
BILHPN Modified PRAPARE_French
BILHPN Modified PRAPARE_Haitian Creole
BILHPN Modified PRAPARE_Pashto
BILHPN Modified PRAPARE_Portuguese
BILHPN Modified PRAPARE_Russian
BILHPN Modified PRAPARE_Spanish
BILHPN Modified PRAPARE_Swahili
BILHPN Modified PRAPARE_Vietnamese