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Primary Care Site Newsletter

In This Issue
Enrollment Numbers
Contact Information
Staff Spotlight
Contracts Corner
300% MassHealth Waiver
Outbound Education and Verification Calls
Consumer Involvement
Western MA SCO Program Staff
Elsie Frank 5 km Road Race
Join Our List
Join Our Mailing List
Enrollment Numbers
As of November 1, 2009 
Senior Care Options (SCO)
= 2330 members
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 Department
Current Member Issues 
Cheryl M. Snyder 
Member Services Manager
617.426.0600 ext. 275

Enrollment & Marketing 
Guillermo Gonzalez
Outreach & Marketing Manager
617.426.0600 ext. 229

Clinical Issues 
Janet T. Norton, RN, CCM
SCO Nurse Clinical Coordinator
617.426.0600 ext. 280

Service Plan Issues 
Annie Halland
Operations Coordinator
617.426.0600 ext. 250

Contracting Issues 
Diane Ryberg
Provider Network Manager
617.426.0600 ext. 254

CaseNET/CER Issues
Ritu Mahajan 
Systems Business Analyst
617.426.0600 ext. 283

Newsletter Submissions 
Nerissa J. Fry
Communications Coordinator
617.426.0600 ext. 244
Staff Spotlight 
Ken Comeiro
Ken Comeiro, NP
Ken Comeiro is a nurse practitioner at Commonwealth Care Alliance Clinical Group. We interviewed Ken to find out a little more about him:

Tell us about yourself:
Born and brought up in the suburbs of Boston. Except for a two year period, where I lived in Maryland, I have been here all my life. I am married to Megan Buckley Comeiro and we live in Billerica with our son Timmy and 2-year-old sometimes person sometimes black lab Delila. I have a passion for a good book or movie, seafood, the Red Sox, home improvement projects, AND of course Dunkin's.
Tell us about your professional background:
I started in the OR at Johns Hopkins in 1994 when nurses were paid $13.25 an hour. I moved back to New England in 1995 and began a long career in Geriatrics, spanning primary care offices, cardiology offices, short-term rehab, long-term care, hospice care, and now home care. I have worked for Johns Hopkins, Lahey Clinic, Symmes Hospital, Heart Center of Metrowest, Evercare, and now Commonwealth Care Alliance.

What does a typical workday look like for you?
Start off with a conference call for one of the many committees I am on or if lucky enough out early to the ASAP* for the news and happenings of the day. Return phone calls and e-mails, start home visits in North Andover then to Haverhill, divert to a crisis somewhere else in Amesbury, come back to original point, pull over to discuss care with a PCP or VNA, then Dunkin' Donuts, family meeting, and more phone calls. Many, many more e-mails, check in with the ASAP*, review upcoming meeting times and/or wound consults in the Boston area to assure all bases are covered. When the coast is clear then home. (*Aging Service Access Point)

What is the best part of your job?
Accomplishing what is deemed the impossible. At times many of our members come to us downtrodden and occasionally hopeless. After a lot of effort and implementation of a service plan, the end result is renewed hope. Giving back quality of life.

What makes Commonwealth Care Alliance special?
The "too good to be true" mantra we hear from potential members that is a reality once they sign on. The collaborative model that is put to work here is like none other in any other program. You can't explain it, just have to experience it.

What do you like to do when you are not at work?
I am a big proponent of "me" time. That consists of getting into a project at home, getting into a book, or getting on the stairmaster at the gym. I love to cook especially grilling and baking. Usually we are on the hunt for a good bargain and can be found at a yard sale, flea market or Salvation Army. Oh, and my sister-in-law got me addicted to Farmville on Facebook.  
If you could invite any five people to dinner, who would you choose?
Horatio Caine (CSI: Miami), Jeff Van Norden of Intervention, Joe Biden, Jerry Remy, and Bob Villa.
New Staff Hires
Hazel Audet, Registered Nurse
Commonwealth Care Alliance Clinical Group
Laura Black, Nurse Practitioner
Commonwealth Care Alliance Clinical Group

Lee Caldwell, RN, Nurse Case Manager
Commonwealth Clinical Alliance 
Zoila Feldman, VP Care Delivery Systems
Commonwealth Care Alliance central office
Brianne Fitzgerald, Nurse Practitioner
Commonwealth Care Alliance Clinical Group
Nicole Gordon, Reconciliation Analyst
Commonwealth Care Alliance central office
Hala Hazar, Business Analyst 
Commonwealth Care Alliance central office
Anita Santana, RN, Nurse Case Manager
Commonwealth Clinical Alliance
Erica Santiago, MA, Clinical Assistant
Commonwealth Clinical Alliance
Jessica Santiago, MA, Clinical Assistant
Commonwealth Clinical Alliance
Peterson St. Fort, Data Management Specialist, Enrollment
Commonwealth Care Alliance central office
Therese Willette, Nurse Practitioner
Commonwealth Care Alliance Clinical Group
Issue 6 Fall 2009
Member with PCA
Bob Master, President & CEODear Network Provider: 
This fall, we at Commonwealth Care Alliance have been extensively involved in a variety of activities on the legislative stage, both at a state level and nationally, as well as with NCQA, to promote the development of more appropriate quality measures for elderly and disabled populations.

In close collaboration with colleagues from Health Care For All, we testified at state hearings related to state payment reform in strong support of the proposal to move toward global payment. Some of us also feel that we have been living in Washington, DC in recent weeks, engaged with the Senate Finance Committee, the Senate Committee on Health, Education, Labor, and Pensions (HELP), the House Tri-Committee, and a variety of advocacy organizations and policy makers in support of national health reform provisions essential to the continued effectiveness of care systems such as ours.

In September, we were honored to be visited by Margaret O'Kane, President of the National Committee for Quality Assurance (NCQA), and an impressive supporting cadre of individuals. NCQA is the nation's preeminent organization responsible for the definition and measurement of quality of care in managed care organizations. Believe me, NCQA certification really means something!

NCQA visited us because they wanted to learn about why we designed our care system the way we have, in order to gain insight into the necessary redesign of quality metrics to more accurately measure care delivery for the populations that we serve. Our NCQA guests were teamed with some of our very capable nurse practitioners and taken on home visits in Greater Boston and Haverhill in order to promote insights and understanding that are simply not possible in the more abstract world of "measurement". Margaret O'Kane and NCQA leadership's desire to spend such an unconventional day with us says a lot about their commitment to getting quality measurement right. That they chose us also says a lot about Commonwealth Care Alliance, and it is something worthy of pride.

Robert J. Master, MD signature
Robert J. Master, MD
President & CEO
Contracts Corner
Please join us in welcoming the following providers to Commonwealth Care Alliance's network:
Contracts Corner Fall 2009
Questions? Please contact Provider Network Management at 617.426.0600 ext. 234
300% MassHealth Waiver Reinstatement
Enrollment applicationsEffective November 1, the 300% MassHealth Waiver was reinstated. This process allows Commonwealth Care Alliance to submit MassHealth applications for seniors with income less than 300% of the federal poverty level (up to $2,022, with no more than $2,000 worth of assets) and a rating category of nursing home certifiable. MassHealth Standard eligibility is a requirement to enroll in our Senior Care Options (SCO) program.
Additionally, the newly reinstated MassHealth Waiver will allow us to re-enroll any member who has lost MassHealth Standard, and therefore their enrollment in our SCO program, if they meet the 300% and rating category criteria.

Questions? Please contact Guillermo Gonzalez, Outreach and Marketing Manager, at 617.426.0600 ext. 229 or
Outbound Education and Verification Calls
Member Service Representative on telephoneBeginning January 1, 2010 Commonwealth Care Alliance's Member Services team will be conducting outbound education and verification calls to all new members within 15 days of receiving their enrollment application. This is a new CMS requirement to ensure that all potential enrollees are educated about plan benefits and to ascertain whether they wish to proceed with the enrollment.

If our Member Services team is unable to reach a new enrollee by phone, they will send them a letter explaining this process and document up to three subsequent attempts to reach the enrollee. Our Outreach & Marketing staff will inform all new members at the time of enrollment that the education and verification calls are now part of the SCO enrollment process.

Questions? Please contact Cheryl Snyder, Member Services Manager, at 617.426.0600 ext. 275 or
Consumer Involvement 
Rosa leads a consumer meeting in SpringfieldCommonwealth Care Alliance members have been busy over the last few months, participating in a number of consumer involvement activities.
Local Consumer Meetings
Two local consumer meetings were held in Springfield in August, attracting close to 100 participants. The groups consisted of both English- and Spanish-speaking SCO members and the bilingual meetings were held in the community room of the Chestnut Accelerated Middle School, close to Brightwood Health Center.
Upham's Corner Health Center hosted two onsite consumer meetings in October for its English-, Spanish-, and Cape Verdean-speaking members. 
Tomando Control de su Salud Workshops
Brightwood Health Center and Elder Service Plan of the North Shore both hosted workshops for Tomando Control de su Salud, the six-week chronic disease self-management program for our Spanish-speaking SCO members. A third group is currently completing this program at our central office in Boston.
Healthy Eating Workshops
Our first Healthy Eating for Successful Living in Older Adults workshop, which recently concluded at Upham's Elder Service Plan, was very successful. Participants learned useful skills during the six-week program to improve their eating habits, such as reading product labels, shopping for nutritious foods, and preparing tasty, healthy meals.
If you're interested in learning how your patients can participate in our health education workshops, please contact Rosa; her contact information is below.
Questions? Please contact Rosa Palacios, Department of Health Education and Caregiver Training, at 617.426.0600 ext. 226 or
Western Massachusetts SCO Program Staff

Commonwealth Clinical Alliance logoAfter the decision by Medicaid not to renew our Medicaid PCC Pilot program contract for FY2010, we are very pleased to welcome the following Pilot staff to new positions in our SCO program in Western Massachusetts, effective October 1.

  • Tony Devoney, RN
  • Meme English EdD
  • Millie Franco, MA
  • Yaritza Gonzalez, MA
  • Jeannette Lopez, CSC
  • Marisol Ramos, RN
Bernie Price, MDOn the same date, Commonwealth Clinical Alliance in Western Massachusetts welcomed a new SCO physician, Bernie Price, MD to their staff. Dr. Price is a graduate of Fairfield University and the University of Vermont, and most recently served as a primary care physician with Baystate Post Acute Medicine and Baystate Brightwood Health Center. Dr. Price is also a Fellow with the American Academy of Family Physicians and a Diplomat with the American Academy of Hospice and Palliative Medicine.

Questions? Please contact Terri Theroux, Western Massachusetts Regional Director, at 413.304.6365 or
Elsie Frank 5 km Road Race
Elsie Frank Road Race participantsCommonwealth Care Alliance participated in the Elsie Frank Meals on Wheels 5 km Road Race, in Dorchester, on September 26.
The annual road race is organized by Kit Clark Senior Services, and all proceeds go toward its programs for seniors in the Greater Boston area.
Elsie Frank, mother of Congressman Barney Frank, was an unyielding advocate for older people maintaining their independence and remaining in their homes and communities as they aged. She was also passionate about ensuring a dignified and respectful approach to elders' care and support, with her poignant assertions that if you want to know how to design services for older people, "ask them". She would have loved Commonwealth Care Alliance's commitment to consumer empowerment and engagement. Lois Simon, our Chief Operating Officer, considers Elsie as one of her mentors, and has a deep admiration for her -- "Elsie was amazing!"
Congratulations to all race participants, in particular, Steven Hochman, Annie Halland, and Jeremy Berk who placed in the top three in their age groups.
If you have submissions or suggestions for this primary care site newsletter, please send me a note via email at or call me during office hours at 617.426.0600 ext. 244.

Nerissa J. Fry
Communications Coordinator 
Commonwealth Care Alliance