Inpatient Facilities

Coordinated Care Network is a Masshealth Behavioral Health Community Partner Program (BH CP). CCN coordinates with enrollees’ health care providers to facilitate engagement and coordinate services including assistance with discharge planning and medication management.

As a consortium of committed providers dedicated to connecting individuals to local services and resources to support wellness, independence, and recovery our mission is to assist individuals with some of the highest healthcare costs and utilization rates in finding more sustainable services that will help them meet their goals.

 

A Partner On The Ground

Coordinated Care Network works with Inpatient Facilities to assist in discharge planning and to help ensure a smooth transition into the community. CCN will work with facilities to ensure that everyone has the most up to date information on the person served and will also provide follow up with medication reconciliation, member education, and general supports to help minimize the need for future inpatient levels of care.

Our care teams are comprised of clinical care managers, care coordinators, and nurses who work on the ground to identify and engage with qualifying individuals. We are able to do this through our strong relationships within the communities. Our emphasis on cultural humility and health equity allows us to connect and engage with Enrollees in their community.

Contact Us Today To Discuss How We Can Work Together

 

Our Services

Coordinated Care Network offers a variety of services that include the following for Enrollees:

  • Comprehensive Assessment and Person-Centered Treatment Planning
  • Care management and coordination across medical, behavioral, and long-term services and supports including:
    • Supporting medication reconciliation and transitions of care
    • Assistance with scheduling medical and behavioral health appointments
    • Assisting with coordination of transportation if needed
    • Assistance with scheduling of routine and physician-suggested treatment
    • Working with insurers to assure no interruptions in coverage and/or assisting in correcting insurance issues that may occur
    • Make referrals for substance use disorder services, specialty programs, in-home supports such as a visiting nurse for medication management or wound care; home health aides, homemaking services, personal care assistance, and transportation resources, including Provider Request for Transportation form (PT-1)
  • Health and wellness coaching
  • Connection to social services and community resources
 

Patient Qualifications:

Masshealth members enrolled in the following Accountable Care Organizations and Managed Care Organizations are eligible to work with CCN.

  • BMC HEALTHNET PLAN
  • BMC HEALTHNET PLAN COMMUNITY ALLIANCE
  • BMC HEALTHNET PLAN SIGNATURE ALLIANCE
  • BMC HEALTHNET PLAN SOUTHCOAST ALLIANCE
  • COMMUNITY CARE COOPERATIVE (C3)
  • STEWARD HEALTH CHOICE
  • TUFTS HEALTH TOGETHER
  • TUFTS HEALTH TOGETHER WITH ATRIUS HEALTH
  • TUFTS HEALTH TOGETHER WITH BIDCO
  • WELLFORCE CARE PLAN

How To Coordinate with CCN:

Contact us today