What Is a Community Partner?
A Community Partner (CP), whether a stand alone organization or a consortium of several organizations, is a MassHealth funded care coordination program serving individuals and families with MassHealth only who are enrolled in an ACO plan. This community based program, launched in 2018, serves to break down barriers and make it easier for MassHealth Members to get access to the care they need, inclusive of basic necessities such as support with housing, employment, food security, and transportation. The CP program employs multidisciplinary teams that collaborate across all providers engaged with a Member to assess care needs, identify barriers and solutions, and promote access while coordinating integrated and quality care for the Member. When enrolled in a CP program, a Member has a designated CP Care Coordinator that partners with them to identify their health needs, supports them in achieving their goals, and advocates for them across the health care system. And Community Partners often collaborate with a Member’s ACO/MCO plan to further enhance access to quality, integrated care. There are two types of Community Partners programs. The Behavioral Health (BH) CP program serves as Lead Care Manager, while the Long-Term Services and Supports (LTSS) CP Program serves as the LTSS expert of the ACO’s complex care management team. Both programs work closely with a Member’s ACO plan and Providers.
Behavioral Health Community Partner
Behavioral Health Community Partners, or BH CPs, provide care management and coordination across the health care continuum for Members with significant BH needs. BH CPs coordinate a Members’ physical health and behavioral health care as well as their LTSS and social services. There are 12 BH CPs across the Commonwealth. Collectively, BH CPs can support up to approximately 45,000-50,000 Members at any one time.
Long Term Services and Supports Community Partner
Long Term Services and Supports Community Partner, or LTSS CP, provide LTSS care coordination for MassHealth Members with complex LTSS needs. They partner closely with an Members’ ACO/MCO plan, serving as the LTSS subject matter expertise on the Care Team. There are 8 LTSS CPs across the Commonwealth. Collectively, LTSS CPs can support approximately 15,000-20,000 Members at any one time.
What is a Medicaid ACO?
An Accountable Care Organization (ACO) is a group of doctors, hospitals, and other health care providers that is responsible for the quality and cost of patient care (including long term services and supports, medical, and behavioral health care, provided to a MassHealth Member). Medicaid ACOs seek to deliver coordinated care to MassHealth Members by contracting with Community Partner organizations in order to improve the experience and quality of care, increase integration among providers across systems of care, and reduce preventable health care costs.
Is a CP program like Community Care Partners an insurance plan?
The Community Partner program is a Care Coordination service funded by MassHealth. The program serves MassHealth Members who are also enrolled within a Medicaid ACO plan. MassHealth continues to be the insurer, and the Medicaid ACO serves as the administrator of MassHealth coverage.