Commonwealth Care Alliance logo

Primary Care Site Newsletter

In This Issue
Enrollment Numbers
Reminders
Contact Information
Staff Spotlight
CaseNET Goes Live
Contracts Corner
Pharmacy Program
SCO Program Clinical Conference
NCQA Health Quality Award
Hospice Provider Issue
Consumer Involvement
Western MA Regional Office Opens
AHRQ Healthcare Innovations Exchange
BCMG Receives Grant
Join Our List
Join Our Mailing List
Enrollment Numbers
As of April 30, 2009 
Senior Care Options (SCO)
= 2067 members
REMINDERS
eFax Numbers

We have supplemented our Member Service fax lines with two new eFaxes. All fax lines are now in operation:
 
Enrollment 617.830.0534
Clinical 617.507.0416
Member Services 617.426.1311
Contact Information
Commonwealth Care Alliance
30 Winter Street
Boston, MA 02108
Telephone 617.426.0600
Enrollment Fax 617.830.0534
Clinical Fax 617.507.0416
MS Fax 617.426.1311
 
Claims Information
Commonwealth Care Alliance
148 State Street, 10th floor
Boston, MA 02109
ATTN: Claims Deptartment
1.800.306.0732
 
Current Member Issues 
Cheryl M. Snyder 
Member Services Manager
617.426.0600 ext. 275
[email protected]

Enrollment & Marketing 
Guillermo Gonzalez
Outreach & Marketing Manager
617.426.0600 ext. 229
[email protected]

Clinical Issues 
Janet T. Norton, RN, CCM
SCO Nurse Clinical Coordinator
617.426.0600 ext. 280
[email protected]

Service Plan Issues 
Annie Halland
Benefits Operations Coordinator
617.426.0600 ext. 250
[email protected]

Contracting Issues 
Diane Ryberg
Provider Network Manager
617.426.0600 ext. 254
[email protected]

CaseNET/CER Issues
Ritu Mahajan 
Systems Business Analyst
617.426.0600 ext. 283
[email protected]

Newsletter Submissions 
Nerissa J. Fry
Communications Coordinator
617.426.0600 ext. 244
[email protected]
Staff Spotlight 
Ritu Mahajan
Ritu Mahajan
Systems Business
Analyst
 
Ritu Mahajan has recently moved into a new role at Commonwealth Care Alliance as Systems Business Analyst, focusing primarily on the CaseNET system. We interviewed Ritu to find out a little more about her:

Tell us about yourself:
I love spending time at home. Whether it's gardening around the house, or just being with my family, I really enjoy the comfort and relaxation of my home. It will be two years in July since I started working at Commonwealth Care Alliance, but it doesn't seem that long. Every day here brings something new and exciting.
 
Tell us about your professional background:
I'm a doctor by profession, graduating from medical school in India. I have a master's degree in Healthcare Administration. I've also worked as a Clinical Analyst.

What does a typical workday look like for you?
My typical workday consists of attending multiple meetings. Lately, I have been working with CaseNET. There's been a lot of planning involved in getting acclimated to this new software.

What is the best part of your job?
The best part of my job is getting the opportunity to work with different people on a whole variety of different projects. By having a hand in a variety of projects, I get to learn new things everyday.

What makes Commonwealth Care Alliance special?
The culture at Commonwealth Care Alliance is very team-oriented. It's a small, but growing company, so everyone knows each other and is happy to extend a helping hand.

What do you like to do when you are not at work?
Outside of my work, I love to tap into my artistic side and work on paintings. I also enjoy spending time with family, and seeing movies with my children.

If you could invite any five people to dinner, who would you choose?
I want to invite all the children in the cast of Slumdog Millionaire. I recently saw the movie with one of my children, and we loved it.
New Staff Hires
December-March 
Christine Ross, Data Entry Specialist/Office Assistant
Commonwealth Care Alliance central office
 
Julio Silva Cunha, Member Services Representative
Commonwealth Care Alliance central office
 
Diana Zegarra, Member Services Representative
Commonwealth Care Alliance central office
 
Marta Limado, LPN 
Commonwealth Clinical Alliance at Brightwood
 
Jacqueline Gonzalez, RN 
Commonwealth Clinical Alliance at Brightwood 
 
Hilda Rosario, RN 
Commonwealth Clinical Alliance at Brightwood  
 
Ruth Rivera, LPN
Commonwealth Clinical Alliance at Brightwood 

Issue 4 Spring 2009
CaseNET Goes Live
Computer keyboarddIt's here.
 
CaseNET, our highly anticipated new care management software, officially went live on March 26 at 8 a.m.

Special acknowledgement and thanks must go to Janet Norton, who has immersed herself whole-heartedly in this project from the very beginning (official kick-off was 3/24/08).
 
Other CaseNET team members deserve recognition as well: Hudson Hardy, Ritu Mahajan, Mary Gugenheim, Ben Coffey, David Pierson, Joe White, and Aweis Abu. This group has overseen the process from planning, to creation, to user-acceptance training, to final implementation.
 
The CaseNET care management solution will enable Commonwealth Care Alliance to take collaborative care to the next level, continuing its commitment to providing members with the best possible care.
 
When any complex software system goes live, users inevitably encounter "bugs" and the CaseNET team is working diligently to find a solution to every known problem. Overall performance of the program has been good and we are tracking emails and calls from clinicians experiencing any problems.
 
Please let us know if there are any issues or "bugs" that are causing you headaches and keeping you from being productive when working in CaseNET. Contact the Help Desk at (617) 269-0299 or via email [email protected].
 
Alternatively, please contact Ritu Mahajan, head of our CaseNET Steering Committee, who is out in the field observing CaseNET in action and looking for ways to improve the system for its users. No matter how the feedback finds its way to us, we want to hear from you!
 
Questions? Please contact Ritu Mahajan, Systems Business Analyst, at 617.426.0600 ext. 283 or [email protected]
Contracts Corner
Please join us in welcoming the following providers to Commonwealth Care Alliance's network:
 

Name

Location

Provider Type

Charlwell House Nursing and Rehabilitation Center

Norwood

Skilled Nursing Facility

Community Care Services

Taunton

Adult Day Health

Community Care Services

Taunton

Behavioral Health

Community Care Services dba Community Care-A-Vans

Attleboro

Transportation

Everett Foot Care PC

Everett

Podiatry

Holyoke Opticians

Holyoke

Optometry

John T. Danielson, OD, PhD

Holyoke

Optometry

Lawrence Memorial Hospital

Medford

Health System

Melrose-Wakefield Hospital

Melrose

Health System

Robert W. Averill

Greenfield

Dermatology

Classic Home Care, Inc

Salem

Certified Home Health Agency

Valzar LLC dba Right At Home

Newton

PCA/Companion

Bay State Medical Equipment Distributors & Supply

Brockton

Durable Medical Equipment

Adventure Inc, dba Loving Care Agency

Springfield

Adult Day Health

Hospice Services of Massachusetts, LLC

Wareham

Hospice

Janice Funk, PhD

Bradford

Behavioral Health

Easton Eye Consultants, PC

North Easton

Ophthalmology

Greater Boston Home Health Care, LLC

Boston

Certified Home Health Agency

Barron Chiropractic & Rehabilitation, PC

Mattapan

Chiropractor

Questions?

Please contact Provider Network Management at 617.426.0600
Pharmacy Program
Rx
The following is a summary of recent pharmacy changes. For more information, please visit our website at www.commonwealthcare.org and click on the "Pharmacy Program" tab.
 
Formulary Changes
Additions: Effective May 1, 2009, the following medications were added to the Medicare Part D formulary:
 
COLESTIPOL HCL GRANULES PACKET
DEGARELIX 2 X 120 MG, 80 MG VIALS
IMITREX 4 MG/0.5 ML SYRNG KIT [QLL]
IMITREX 6 MG/0.5 ML SYRNG KIT [QLL]
LIQUADD 5 MG/5 ML SOLUTION
OPANA ER 5, 7.5, 10, 15, 20, 30 & 40 MG TABLET
PREDNISONE 5 MG/ML SOLUTION
REPREXAIN 2.5-200, 5-200 & 10-200 MG TABLET
ULORIC 40 & 80 MG TABLET [ST]
VIMPAT 50, 100, 150 & 200 MG TABLET
XENAZINE 12.5 & 25 MG TABLET

Questions? Contact Basem Shebli, Pharmacy Director, at 617.426.0600 ext. 238 or [email protected]
SCO Program Clinical Conference
Award recipientThe third annual SCO Program Best Practice Clinical Conference will be held at Regis College in Weston, on Friday, May 15, 2009.
 
The conference is an excellent opportunity for SCO primary care team members, including physicians, nurses, nurse practitioners, clinical assistants, and GSSCs, to participate in a daylong conference and to share their experiences and challenges with colleagues from across the state.
 
This year's topic addresses end-of-life care issues for the SCO-eligible population. The uniqueness of care delivery as part of Commonwealth Care Alliance's SCO model will be explored, and specific best practice initiatives will be presented to promote interdisciplinary team work when transitioning from life extension to palliative care.

Questions? Contact Jan Levinson, Director of Program Development, at 617.426.0600 ext. 222 or [email protected]
NCQA Health Quality Award
Bob Master accepts NCQA awardBob Master, Commonwealth Care Alliance's President and CEO, was honored March 18 at NCQA's annual Health Quality Awards event in Washington, DC. Bob received this recognition for his leadership in improving the quality of care for vulnerable populations.
 
Bob shared the limelight with three other honorees (Peter Orszag, PhD, who serves as President Obama's Director of Management and Budget; the Cystic Fibrosis Foundation; and Representative Diane Degette of Colorado). Mara Liasson, a National Political Correspondent for National Public Radio, served as the Master of Ceremonies.
 
"It was such an honor to be recognized alongside the other recipients - they are all so incredibly hardworking and passionate about improving health care," said Dr. Master.
 
Previous award recipients include US Senator Edward M. Kennedy, Secretary of State Hillary Rodham Clinton, and US Surgeon General David Satcher.
 
Click here to download the press release. Photo credit: Ralph Alswang.
 
Questions? Contact Nerissa Fry, Communication Coordinator, at 617.426.0600 ext. 244 or [email protected]
Hospice Provider Issue
Commonwealth Care Alliance covers hospice services for our SCO members; this helps us provide seamless care and care coordination over the span of our members' lives.

To avoid disruption to this coordination, it is very important that you:
  • Refer SCO members to only our contracted hospice providers
  • Ensure SCO members do not sign Medicare 'election' forms
  • Remind hospice providers that Commonwealth Care Alliance, not Medicare pays for hospice care for our SCO members

We have recently clarified the matter of payment with our contracted hospice providers, but it is also important to remind them at the time of patient referral that their claims should be sent to Commonwealth Care Alliance, not Medicare.

If circumstances require a referral to a non-contracted hospice, or if you would like a list of contracted hospice providers, please call Diane Ryberg at (617) 426-0600 ext. 254.

Questions? Contact Annie Halland, Benefits Operations Coordinator, at 617.426.0600 ext. 250 or [email protected]

Consumer Involvement 
Member at local consumer meetingLocal Consumer Meetings
Commonwealth Care Alliance recently held its first Vietnamese language local consumer meeting at Dorchester Multi-Service Center.
 
Internal staff members Silai Son and Huyen Ngo helped translate as Rosa Palacios facilitated the meeting, which was attended by a large group of members from the Dorchester area.
 
To date, we have conducted our local consumer meetings in four languages other than English. We look forward to reaching even more of our diverse member population as we plan meetings in additional languages and in other communities around the state.
 
My Life, My Health
My Life, My Health is a Stanford Chronic Disease Self-Management program, where participants learn to live better with long-term chronic conditions. 
 
Commonwealth Care Alliance has held a number of "My Life, My Health" workshops in and around Boston, and will have more early this year. We have also planned a leader training, to train our members to teach the program to their peers.
 
Participant workshops for "My Life, My Health" run for two and a half hours, once a week for six weeks. The next programs will be held in the Springfield, Boston and Lynn areas beginning Spring 2009.
 
Questions? Please contact Rosa Palacios, Department of Health Education and Caregiver Training, at 617.426.0600 ext. 226 or [email protected]
Western MA Regional Office Opens
Commonwealth Clinical Alliance logoThe Commonwealth Clinical Alliance Western Massachusetts regional office has opened in Springfield. This new space will be utilized by our SCO program staff from Holyoke Health Center, Chicopee Health Center, Mason Square Health Center, and High Street Health Center. They can be contacted as follows:
Commonwealth Clinical Alliance
Western Massachusetts Regional Office
140 High Street, Suite 300
Springfield, MA  01105
Telephone: 413.306.3599
Fax: 413.306.3595
Communications regarding SCO program members who are patients at Brightwood Health Center, should still be directed to our Commonwealth Clinical Alliance staff at Brightwood.

Questions? Please contact Lisette Antonmarchi, Regional Office Manager, at 413.306.3599 or [email protected]
AHRQ Healthcare Innovations Exchange
Commonwealth Care Alliance is participating, by invitation, in the Healthcare Innovations Exchange, a comprehensive program designed by the U.S. Agency for Healthcare Research and Quality (AHRQ) to accelerate the development and adoption of pioneering practices in healthcare delivery. As doctors, nurses, healthcare providers, and policy-makers struggle to improve care for elderly and chronically ill patients, Commonwealth Care Alliance's presence in this online forum serves as a resource and example for successful primary care delivery for vulnerable populations.
 
The Healthcare Innovations Exchange is an online community of ideas that is focused on increasing awareness of groundbreaking strategies and methods for health care providers. Every day, health care practitioners find more effective ways of delivering health care. The diffusion of ideas, however, is often slow and ineffective. The Innovations Exchange provides a solution to this problem by creating a central repository of searchable innovations and tools that health care practitioners can turn to for new ideas.
 
As Commonwealth Care Alliance leads the charge in improving primary care and social support services for the elderly and chronically ill populations, membership in the Innovations Exchange helps Commonwealth Care Alliance share the advantages that coordinated, patient-governed health care has for these populations. 
 
Visit Commonwealth Care Alliance's profiles on the Innovations Exchange at the AHRQ's web site: Click here for profile one. Click here for profile two.
BCMG Receives Quality of Life Grant 
Each year the Christopher & Dana Reeve Foundation awards grants to non-profit organizations that provide services to individuals living with paralysis. This year the Foundation was proud to announce Boston's Community Medical Group as one of the 145 recipients; BCMG will receive $15,500 in aid.
 
BCMG will use the grant to help those living with paralysis to become active members in everyday life.
 
BCMG is part of the Commonwealth Care Alliance organizational family and we are proud that their work has been rewarded with this grant.
If you have submissions or suggestions for this Primary Care Site newsletter, please send me a note via email at [email protected] or call me during office hours at 617.426.0600 ext. 244.
 
Sincerely,

Nerissa J. Fry
Communications Coordinator 
Commonwealth Care Alliance