MA DSRIP TA - OTS Application

You have elected to submit a TA application for an Off the Shelf TA Project. Please complete this form to initiate a MassHealth Technical Assistance (TA) project.

ACOs and CPs currently have access to TA Funding available on the Year Four and Year Five TA Cards. Year Four TA Cards expire December 31, 2021, and Year Five TA Cards expire June 30, 2022. All TA Projects must be completed by September 30, 2022. If you have questions, please contact us.

MassHealth and Abt Associates (the TA Program Managing Vendor) will review your TA application to ensure that your preferred TA Vendor has the capacity to work with you at this time.

We will reach out to you if we have questions about your TA application and send an email to you and the listed TA Vendor once your TA application is approved.

Following approval of your TA application, you will be free to work with the TA Vendor to create a detailed Scope of Work (SOW) and budget for your TA project following the guidance provided to TA Vendors by Abt Associates. The SOW should address any customization to the project needed by your organization. Abt Associates and MassHealth must review and approve all SOWs and budgets prior to the start of any TA project work.

More information about accessing TA is available at How to Use Your TA Card.

* questions require a response

1. Please identify the Off the Shelf TA Project for which your ACO/CP would like to submit this TA Application. First select the Domain, then select the TA Vendor with Off the Shelf projects in the Domain, and finally select from the available projects offered by the selected TA Vendor. *This question is required.

TA Domain
TA Vendor
Off the Shelf TA Project

2. Is your organization an ACO or a CP? *This question is required.

3. Which TA Card is supporting this TA project? (please select all that apply) *This question is required.

Year Four
Year Five

4. Please identify the person in your ACO or CP who is directly accountable for the progress and successful completion of the requested TA: *This question is required.

Name:
Title:
Organization:
Email:
Phone number:

5. Please identify the Competency Area(s) the requested TA is intended to strengthen: *This question is required.

Core Competency 1: Respect, understand, and engage MassHealth members
Core Competency 2: Honor, enlist, and develop provider and care team insights and capabilities
Core Competency 3: Access, apply, and exchange data across all entities involved in MassHealth member wellness and care
Core Competency 4: Develop and implement financial models that promote provider and staff buy-in and advance the achievement of quality benchmarks, appropriate utilization of care, and long-term organizational sustainability
Core Competency 5: Provide coordinated care and/or complex care management that is highly responsive to MassHealth member needs and preferences
Core Competency 6: Actively develop and maintain a foundation of, and disseminate up-to-date knowledge in, all areas relevant to building and running a high performing, sustainable MassHealth ACO or CP

6. Please explain how the requested TA will strengthen your ACO/CP within your identified Competency Area(s). (Max: 3 paragraphs) *This question is required.

7. If there is overlap between the requested TA and the work supported by DSRIP Participation Plan funds, please explain how the requested TA is not duplicative of other DSRIP-supported efforts. (Max: 3 paragraphs) If there is no overlap, please write “not applicable.” *This question is required.

8. Please describe how the proposed TA project will advance the goals outlined in your DSRIP Participation Plan. If your proposed TA project does not align with your DSRIP Participation Plan goals, please provide a brief rationale. (Max: 2 paragraphs) *This question is required.

9. Please enter the anticipated start and end date for the proposed OTS project.

Start date

End date