As a One Care plan, Commonwealth Care Alliance to serve dual eligibles in nine counties
Boston, September 6, 2013 — Commonwealth Care Alliance announced today that it has signed a contract with MassHealth (Medicaid) and the Centers for Medicare & Medicaid Services (CMS) (Medicare) to participate in the new Massachusetts’ One Care: MassHealth plus Medicare program, which begins on October 1, 2013. The One Care program in Massachusetts will be the first demonstration program for dual eligible under the Affordable Care Act (ACA) to launch in the country.
“This contract is the result of a great collaboration with the state, CMS, advocates and stakeholders. We are thrilled to participate in this ground-breaking program,” said Dr. Robert Master, CEO of Commonwealth Care Alliance. “As an approved One Care plan, Commonwealth Care Alliance will be able to give individuals in the disability community access to enhanced health and community support services delivered through an integrated, person-directed care model.”
Commonwealth Care Alliance is one of three plans that have signed agreements to enroll members under the One Care Program effective October 1. Commonwealth Care Alliance will have the largest service area in the State, with services available to eligible residents of Essex, Franklin, Hampshire, Hampden, Middlesex, Norfolk, Plymouth (partial), Suffolk and Worcester counties.
One Care is a new health care option for Massachusetts adults, ages 21 to 64, with complex medical conditions or other qualifying health conditions, including physical disabilities, developmental disabilities, or mental health conditions, who are eligible for both MassHealth and Medicare coverage. One Care plans will coordinate a wide range of services to support a member’s individual needs, including all medical and community-based services that are currently covered by Medicare and MassHealth, in addition to enhanced services such as dental and other community-based supports. The program is designed to promote member choice and direction in an integrated team-based approach and eliminate the confusing and fragmented access to services that exists in the current system for people eligible for both Medicare and Medicaid.
Dual eligible beneficiaries are among the most vulnerable and most costly patients in the healthcare system. On average, duals cost five times more to care for than the average Medicare beneficiary. Since 2003, Commonwealth Care Alliance, in partnership with its primary care network and its clinical affiliate Commonwealth Community Care has helped to improve care, and contain and stabilize medical costs for elderly adults and younger individuals with serious disabilities by providing personalized, comprehensive care.
For more information about One Care: Mass Health plus Medicare, please visit www.mass.gov/masshealth/duals.
About Commonwealth Care Alliance
Commonwealth Care Alliance is a nonprofit care delivery system committed to providing integrated health care and related social support services. Created in 2003, Commonwealth
Care Alliance is a “consumer-governed” organization offering a full spectrum of medical and social services for people with complex needs covered under Medicaid and for those “dually eligible” for both Medicaid and Medicare. Commonwealth Care Alliance offers the Senior Care Options Program (HMO SNP) for dual eligible individuals ages 65 and older, and will soon be administering One Care: MassHealth plus Medicare, for dual eligible individuals ages 21 to 64. These comprehensive health plans provide all the services covered under Medicare and MassHealth, and other benefits as determined necessary by an interdisciplinary primary care team. Services are coordinated by the primary care team and are accessed through Commonwealth Care Alliance’s preferred provider network.
For more information on Commonwealth Care Alliance, visit www.commonwealthcare.org or call 1-866-610-2273.
Commonwealth Care Alliance is not affiliated with the Commonwealth Health Insurance Connector Authority’s Commonwealth Care program.
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