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Program Statistics |
Senior Care Options Enrollment
2,889 members
Gender
68% = female; 32% = male
Clinical Overview
56% diabetic; 23% with CHF Network Health Alliance
Enrollment
2,613 members
Gender
59% = female; 41% = male |
| 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
148 State Street, 10th floor
Boston, MA 02109
ATTN: Claims Department
1.800.306.0732
Current Member Issues
Cheryl M. Snyder
Member Services Manager
Enrollment & Marketing
Robert Katzman
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
Quality Issues
Kerry Markert
Quality Program Manager
617.426.0600 ext. 261
Contracting Issues Diane Ryberg Provider Network Manager
617.426.0600 ext. 254
CaseNET/CER Issues Ritu Mahajan Systems Analyst
617.426.0600 ext. 283 |
| Staff Spotlight |  |
Anita has been a part of our Western Massachusetts clinical group for over 12 months.
Tell us about yourself: I'm a single parent of 2 kids--Joel, aged 14, and Quiana aged 11. I'm also currently pursuing a Bachelor's Degree in Nursing.
Tell us about your professional background: I started as a certified nurse assistant at the age of 17, then later received an Associates Degree in Science in Medical Assisting, followed by an Associates Degree in Science in Nursing. I have been a nurse for 9 and a half years.
What does a typical workday look like for you? I turn on my work cell phone at 8 a.m. and leave it on until 6 p.m. I usually head into the office first to check my mailbox and messages. Some days I stay in the office to catch up on documentation, other days, I schedule home visits.
What is the best part of your job? Patient care--being able to see what a positive difference our program makes for patients and their families. What makes Commonwealth Care Alliance special? The team approach allows you to case conference with team leaders, supervisors, fellow nurses, medical assistants, geriatric support services coordinators, etc. It opens up your eyes to other possibilities to better care for our patients.
What do you like to do when you are not at work? I like to shop, dance, cook, and enjoy my time with my children, family, and friends.
If you could invite any five people to dinner, who would you choose? Denzel Washington--I have all his movies; Marc Anthony--I have all his CDs; Rajon Rondo from the Celtics--an amazing young man with such great potential (and my son's favorite player); Oprah Winfrey--such a powerful and inspirational woman; and lastly, Paula Deen--I watch her on the Food Network every weekend. I enjoy making her recipes and she looks like a lot of fun!
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| New Staff Hires
September-October |
Commonwealth Clinical Alliance
Judith Ackerman
Administrative Assistant
Margaret Ackerman
Director of Clinical Education & Training
Danielle Adamczyk
Nurse Practitioner
Celio Freitas
Community Health Worker
Johanne Jeudy
Nurse Practitioner
Gail Kundrot
Behavioral Health Care Manager
Nicole L'Heureux
Nurse Practitioner Care Manager
Commonwealth Care Alliance
Lawrence Gottlieb
Senior Vice President for Medical Affairs & Chief Quality Officer
Robert Katzman
Outreach & Marketing Manager
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Dear Network Provider:
What do the election results mean for Commonwealth Care Alliance and health care reform? First and foremost, the Affordable Care Act (ACA) and its many provisions that align with our mission will not be repealed outright for the next two years. However, a lot of political sand is expected to be thrown in the gears once the new House leadership hit their stride in 2011 and begin a widespread discrediting of the ACA in preparation for the 2012 presidential elections.
We can expect strong efforts to stifle health care reform through the budget process. Continued appropriations for CMS' Center for Innovation and the Federal Coordinated Health Care Office will be targeted and this could certainly affect us. If the effort to impede the mission of these new offices within CMS succeeds, then the policy goals of Medicare and Medicaid integration and widespread care innovation could be compromised. However, there are lots of cards to be played to prevent that from happening.
Commonwealth Care Alliance is working closely with similar innovative care delivery systems in other states, the Federal Coordinated Health Care Office and CMS' Center for Innovation to be in the vanguard of "shovel ready" initiatives that can move quickly to implementation. We are also planning to increase our lobbying effort and voice with Congress to promote the important elements of the ACA to which we can credibly speak.
This is certainly a challenging political and fiscal context in which we operate but, as always, Commonwealth Care Alliance is actively engaged in efforts to be part of the solution.
Robert J. Master, MD President & CEO |
| Public Policy and Advocacy |  Get to Know SCO
In an effort to raise the profile of Senior Care Options--the publicly funded program that helps low-income seniors maintain health and independence at home which some call the "best kept secret in health care"--the four senior care organizations in Massachusetts, Commonwealth Care Alliance, Navicare, Evercare, and Senior Whole Health, joined forces recently to launch a "Get to Know SCO" campaign.
The "Get To Know SCO" State House event included a keynote address by State Senator Richard T. Moore. "We're always talking about Accountable Care Organizations or Medical Homes as the future of health care, and what people don't know is that SCOs have been doing this for years, and it works," said Senator Moore, chairman of the Health Care Financing Committee and author of the legislation that created SCOs. "SCOs represent the model for how we should be providing care in the community," he said.
The SCO plans are asking the state to do more to inform people about the availability of the program and the value it brings to health care for a very vulnerable population.
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| Program Developments |  Ethics Committee
Commonwealth Care Alliance launched its Ethics Committee earlier this year, chartered by our Board of Directors and the Patient Care Assessment Committee to support the full implementation of the organization's core values across all clinical programs. Its members consist of front-line clinicians, experienced bioethics professionals, Commonwealth Care Alliance Board members, and organization leaders. The committee is chaired by Judi Friedson, a clinical ethics consultant, who serves in a similar capacity at Children's Hospital and Tewksbury Hospital.
The Commonwealth Care Alliance Ethics Committee is charged with providing consultation services to help clarify and resolve ethical conflicts at a clinical or organizational level, and to disseminate educational resources that enhance the ability of clinicians and managers to engage in ethical decision-making.
Since January, the committee has used its monthly meetings to educate its members, define the scope of its activities, and develop policies and procedures with respect to its consultation and educational mandates. Recently, Bernice Ezell, nurse practitioner based at Brightwood Health Center in Springfield, presented the first case for discussion.
Over the coming months, the committee will be communicating with Commonwealth Care Alliance staff and providers about its work and its availability for consultation.
Questions? Please contact Adam Burrows, Senior Care Options Medical Director, at 617.426.0600 ext. 237 or aburrows@commonwealthcare.org |
| Contracts Corner |
Please join us in welcoming the following providers to Commonwealth Care Alliance's network:
|
Name |
Location |
Provider Type | |
ABC Health services, Inc. dba Bazin Chiropractic |
East Longmeadow |
Chiropractic | |
Sleep Disorder Center of Hampden County |
Southwick |
Sleep Disorder Center | |
Noble Visiting Nurse and Hospice Services Inc. |
Westfield |
Hospice | |
Professional Medical Services, Inc. |
West Springfield |
Transportation | |
Grove Hill Medical Center, PC |
Springfield |
Ophthalmology | |
Pioneer Valley Plastic Surgery, LLC |
Springfield |
Plastic Surgery | |
National Ambulance, LLC |
Springfield |
Ambulance | |
Robert M. Berger, MD, PC |
Springfield |
Ophthalmology | |
TransCare Mobile Health Services, PC |
Milford |
Specialty Group | |
Katherine Ruiz-Mellott, MD |
Haverhill |
Behavioral Health | |
Inspire Medical Equipment & Services, Inc. |
Haverhill |
Durable Medical Equipment | |
Desjardins Management Inc. dba Community Dentists |
Lowell & Lawrence |
Dental | |
Lawrence Dental Center |
Lawrence |
Dental | |
Merrimack Valley Health Care Group |
Methuen |
Primary Care Site | |
Vascular and Vein Associates, PC |
Methuen |
Vascular Surgery | |
Psychiatric Associates of Lynn, PC |
Lynn |
Behavioral Health Outpatient | |
Hatch Hearing Aid Center |
Lynn |
Durable Medical Equipment | |
HealthPro Physical Therapy, Inc. |
Lynn |
Physical Therapy | |
North Shore Medical Center-Cardio-Heart & Wellness |
Lynn |
Cardiology | |
Pulmonary Physicians, PC |
Lynn |
Pulmonary Disease | |
North Shore Adult Day Health Center, LLC |
Lynn |
Adult Day Health | |
In-Home Counseling-Catherine A. Galenius, MSW, LICSW |
Saugus |
Counseling | |
North Shore PRN |
Beverly |
Certified Home Health Aide | |
We Care Breast Forms & Accessories |
Beverly |
Durable Medical Equipment | |
Kay O'Laughlin, EdD |
Gloucester |
Behavioral Health Outpatient | |
Parrelli Optical |
Gloucester |
Vision | |
Gurley Eye Care Associates |
Manchester |
Ophthalmology | |
The Lafayette Rehab & Skilled Nursing Facility |
Marblehead |
Skilled Nursing Facility | |
Bring Home Care, Inc. |
Topsfield |
Aging Services Access Point | |
Visions of Independence |
Sharon |
Occupational Therapy | |
Downtown Crossing Podiatry |
Boston |
Podiatry | |
Bay Cove Human Services, Inc. Center House Psychiatric Day Treatment |
Boston |
Behavioral Health Outpatient | |
Bay Cove Human Services, Inc. Treatment Center |
Boston |
Behavioral Health Outpatient | |
Habit OPCO |
Boston |
Behavioral Health Outpatient | |
Bay Cove Human Services, Inc. Day Habilitation |
Boston |
Behavioral Health Outpatient | |
Bay Cove Human Services, Inc. Kit Clark Mental Health Clinic |
Dorchester |
Behavioral Health Outpatient | |
Kit Clark Senior Services, Inc. Adult Day Health |
Dorchester |
Adult Day Health | |
LT Dental, PC |
Dorchester |
Dental | |
Mass Bay Urologic Associates PC |
Dorchester |
Urology | |
Second Wind Physical Therapy & Sports Medicine |
East Boston |
Physical Therapy | |
Spinelli's |
East Boston |
Meals on Wheels | |
Bay Cove Human Services, Inc. Michael J. Gill Mental Health Clinic |
Jamaica Plain |
Behavioral Health Outpatient | |
Bay Cove Human Services, Inc. PACT |
Jamaica Plain |
Behavioral Health Outpatient | |
USA Vein Clinics of Boston LLC |
Boston |
Vascular Surgery | |
Retina Specialists of Boston |
Cambridge |
Vision | |
Everett Nursing Home and Rehabilitation Center |
Everett |
Skilled Nursing Facility | |
Bay Cove Human Services, Inc. Chelsea ASAP Outpatient Services |
Chelsea |
Behavioral Health Outpatient | |
Omni Dentix & Associates |
Medford |
Dental | |
Bay Cove Human Services, Inc. Andrew House |
Quincy |
Behavioral Health Outpatient | |
Bay Cove Human Services, Inc. New Hope Transitional Support Services |
South Weymouth |
Behavioral Health Outpatient | |
Metropolitan Home Care |
Brookline |
Certified Home Health Aide | |
Middlesex Health Care Agency, LLC |
Waltham |
Homemaker/Personal Care, Chore Services | |
Zdorovie Senior Service |
Newton |
Adult Day Health | |
Boston Orthotics, Inc. |
Taunton |
Durable Medical Equipment | |
Bay State Transportation Company, Inc. |
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Transportation | |
Havana Medical Equipment dba Allstate Medical Supply |
Miami |
Durable Medical Equipment |
Questions? Please contact Provider Network Management at 617.426.0600 ext. 234
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If you have submissions or suggestions for this primary care site newsletter, please send me a note via email at nfry@commonwealthcare.org or call me during office hours at 617.426.0600 ext. 244.
Sincerely,
Nerissa J. Fry
Communications Coordinator
Commonwealth Care Alliance |
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