Commitment to Quality

We consistently pursue new ways to improve the quality of care offered to our members. This includes:

  • Regularly measuring health outcomes and setting goals for improvement
  • Developing useful toolkits for members with common conditions such as asthma and diabetes 
  • Participating in state-sponsored programs that aim to enhance the level of care provided to our members, like MassHealth's latest initiative to bring Accountable Care Organizations (ACOs) to Massachusetts. This program aims to find efficiencies in the health care system through enhanced data sharing, improved communication between providers and health plans, and care that goes beyond the exam room and is more personalized to a member's daily routine.

Knowing Our Members

We assess the physical, social and emotional health of our members and the communities in which they live in order to develop health plans to improve health outcomes.

Supporting Their Needs

Improved health involves more than meeting basic medical needs. At BMC HealthNet Plan, we manage the physical, social and emotional needs of our members in order to:

  • Address social determinants of health such as housing needs, food insecurity and lack of education
  • Collaborate with providers, including behavioral health specialists, hospitals and long-term care facilities
  • Manage costs and quality of care through our population health, disease, care management and utilization management programs.
  • Establish needs and monitor progress of our populations using data and analytics

Achieving Healthy Outcomes

Our efforts contribute to improving health outcomes and lowering costs. We recognize that factors outside of traditional healthcare have a significant impact on health and we make investments to support:

  • Healthier homes
  • Safer neighborhoods
  • Healthy habits

In fact, we have a team devoted to improving the health outcomes of our membership. In this quality report you can find the latest results of their efforts. 

Key Partnerships

We partner with providers and community organizations to meet the medical, social and emotional needs of our members.

  • 17,900 primary care, specialists & behavioral health providers
  • 53 acute care hospitals
  • 4 MassHealth ACO partners
  • 92 community organizations
  • 25 community health centers
BMC HealthNet Plan maintains NCQA Commendable Accreditation  for our MassHealth program.
Commendable Accreditation for our Massachusetts Medicaid HMO product.
NCQA accredited for our QHP program.
Accredited status for Qualified Health Plan product, the highest status available for this product.
Named as a 2017 Healthiest Employer by the Boston Business Journal.
Among the first to adopt the pledge aimed at combating the stigma of mental illness.

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