What is an LTSS Community Partner?
MCCN is one of eight MassHealth Long Term Services & Support (LTSS) Community Partners (CP) working closely with Accountable Care Organizations (ACO) and Managed Care Organizations (MCO) to achieve the triple aim of improved patient experience of care, improved health outcomes, and reduced cost of care for MassHealth Enrollees.
- The LTSS CP care model provides individuals with complex lifelong needs with access to care coordination services conducted by community-based providers who have the expertise and capabilities to best support them.
- MCCN Care Coordinators work closely with individuals to develop a LTSS Care Plan that is approved by the Primary Care Physician and shared with the Care Team.
- All of an individual’s health and service providers communicate to monitor and provide linkages with one another, to address an individual’s unique social, physical, and behavioral health needs in a comprehensive way.
- The LTSS CP care model is known to improve the health outcomes of individuals with LTSS needs and reduce the use of inpatient and emergency room care.
MCCN LTSS Community Partner Network
The strength of the Massachusetts Care Coordination Network (MCCN) - a MassHealth Long Term Services and Supports Community Partner (LTSS CP) - is in the breadth and scope of our Partner network.
Our Network Includes:
- Long Term Services and Supports Provider Organizations (LTSS)
- Independent Living Centers (ILC)
- Aging Services Access Points (ASAP)
Our Network connects Enrollees with access to a wide-array of wrap-around supports with through strong, collaborative relationships and connections to:
- Behavioral Health Provider Organizations
- Other LTSS Providers
- Social Service Providers
How Does MCCN Coordinate Care?
MCCN care coordination involves a broad range of support functions that assist individuals to better navigate and receive long term services and supports and to improve coordination of their care and care outcomes. MCCN’s experienced Care Coordinators and staff work closely with each individual to provide the following services:
- Outreach and Engagement
- LTSS Care Planning including Choice Counseling
- Care Team Participation
- LTSS Care Coordination
- Support for Transitions of Care
- Health and Wellness Coaching
- Connection to Social Services and Community Resources, including Flexible Services
How Can MCCN Help You & Your Clients?
- Supports ACOs in achieving care coordination and management goals
- Develops an LTSS Care Plan to ensure comprehensive, integrated care
- Respects ACOs’ critical role in supporting the individual
- Collaborates efforts to break down existing silos and deliver integrated care
- Helps members and their families navigate the complex system of LTSS care in Massachusetts
- Works as an additional resource for ACO clients to meet their LTSS needs
- Coordinates community supports
- Promotes community first, person-centered & independent living, aging in place, and cultural competence
Why Choose MCCN for Care Coordination?
- Massachusetts Care Coordination Network (MCCN) is a partnership of highly qualified health and human service agencies that provide exceptional, integrated comprehensive care coordination to people who are enrolled in MassHealth that have complex lifelong needs.
- MCCN Care Coordinators are knowledgeable about people with complex lifelong needs, resourceful, respectful, and available at flexible hours of the day that meet your needs, as well as the needs of your clients.
- By coordinating care, MCCN takes the best resources available and matches supports to each person’s needs. MCCN provides the tools that help people build self-directed, fulfilling lives.
- MCCN Care Coordinators operate in Northern, Central, and Southern Massachusetts and contract with all Accountable Care Organizations (ACO) and Managed Care Organizations (MCO) in these regions.