Massachusetts received approval from the Centers for Medicare and Medicaid Services (CMS) on December 20 for the renewal and extension of its MassHealth demonstration waiver program through June 30, 2014. The Commonwealth’s goals under the demonstration program include maintaining near-universal health coverage; redirecting health care spending away from episodic uncompensated care in high cost settings to more cost-effective health insurance coverage; accomplishing delivery system reforms fostering person-centered care planning, better care coordination, chronic disease management, and improved treatment outcomes; and promoting payment reforms to incentivize providers to focus on quality of care and achieving results for patients rather than generating service volume. Exemplary features of the waiver program include Delivery System Transformation Initiatives funded through the Safety Net Care Pool under which participating hospitals will have opportunities to qualify for incentive payments for measurable improvements in quality and efficiency of care. The waiver program will also use streamlined eligibility procedures to renew eligibility for parents with children enrolled in the Supplemental Nutrition Assistance Program, expand evidence-based early intervention services for children with autism spectrum disorder, and create a new pilot program for children with high-risk asthma conditions to reduce the risk of costly emergency room episodes and inpatient hospital admissions.