Overview of Community Care Cooperative (C3)
Community Care Cooperative (C3) is a non-profit, FQHC-led ACO established in 2016 by nine Massachusetts FQHCs. Our mission is to improve health and wellness through coordinated, community-based care, focusing on underserved populations. As the only ACO in Massachusetts founded and governed by FQHCs, C3 leverages collective strengths to enhance care delivery and outcomes.
1.1. Mission and Vision
Community Care Cooperative (C3) is a non-profit, FQHC-led ACO dedicated to improving health and wellness through coordinated, community-based care. Our mission is to leverage the collective strengths of Federally Qualified Health Centers (FQHCs) to address the unique needs of underserved populations in Massachusetts. We aim to enhance care delivery, improve health outcomes, and reduce disparities by fostering innovation and collaboration. Our vision is to create a sustainable, patient-centered care model that integrates primary care, behavioral health, and social services, ensuring equitable access to high-quality healthcare for all members.
1.2. Structure and Governance
Community Care Cooperative (C3) is a non-profit, FQHC-led Accountable Care Organization (ACO) established in 2016 by nine Massachusetts FQHCs. It operates as a member-governed organization, with a board of directors composed of representatives from each FQHC member. This structure ensures equitable decision-making and aligns with its mission to serve underserved populations. C3 is also a participant in the MassHealth ACO Program, focusing on advancing integrated, community-based care.
As a 501(c)(3) organization, C3 is committed to transparency and accountability, adhering to federal and state regulatory requirements. Its governance model emphasizes collaboration and shared responsibility, enabling C3 to effectively address the healthcare needs of its members while maintaining financial and operational integrity.
1.3. Role in Massachusetts Healthcare
Community Care Cooperative (C3) plays a vital role in Massachusetts healthcare as a non-profit, FQHC-led ACO. Established to participate in the MassHealth ACO Program, C3 focuses on improving care delivery for underserved populations. By leveraging the strengths of its FQHC members, C3 enhances access to coordinated, community-based care. Its initiatives aim to address health disparities, improve health outcomes, and reduce costs through value-based care models. C3’s efforts are central to advancing Massachusetts’ healthcare goals, ensuring high-quality, patient-centered care for its members.
Key ACO Programs and Initiatives
Community Care Cooperative (C3) implements innovative programs like the Care Management Program and SHIFT-Care Challenge, focusing on value-based care and addressing social determinants of health.
2.1. Care Management Program
The Care Management Program at Community Care Cooperative (C3) is designed to ensure seamless coordination of care for members, particularly those with complex needs. The program includes a structured timeline for members admitted to facilities, ensuring timely interventions and transitions. Providers can refer patients to care management services, which include comprehensive care needs screenings and coordination with community partners. A key focus is integrating long-term services and supports (LTSS) and behavioral health programs to address the whole person. This approach enhances quality of care, reduces hospital readmissions, and improves overall health outcomes for members.
2.2. SHIFT-Care Challenge Summary
The SHIFT-Care Challenge is an innovative initiative by Community Care Cooperative (C3), aimed at fostering sustainable healthcare transformations. Launched in 2018, this 18-month program invests $10 million in addressing health-related social needs and enhancing behavioral health care. The challenge focuses on two tracks: improving social determinants of health and advancing behavioral health services. By supporting innovative solutions, C3 seeks to reduce disparities and improve care coordination, ensuring better health outcomes for vulnerable populations. This program underscores C3’s commitment to value-based care and community-centered innovation.
2.3. Covered Services and Benefits
Community Care Cooperative (C3) offers a comprehensive range of covered services and benefits, focusing on primary care, preventive services, and chronic disease management. Behavioral health services, including counseling and substance use treatment, are integrated into care plans. The program also addresses health-related social needs, such as housing and food insecurity, through community partnerships. Benefits include access to care coordination, wellness programs, and specialty referrals. C3 ensures members receive holistic, patient-centered care, emphasizing prevention and early intervention. Detailed service listings and benefit information are available in the C3 Provider Manual and Member Handbook.
Community Care Cooperative’s Provider Manual
The Provider Manual provides comprehensive information about C3 programs, regulatory requirements, policies, and procedures. It serves as a guide for providers to ensure compliance and effective care delivery.
3.1. General Information
The Provider Manual begins with a general overview of Community Care Cooperative (C3), outlining its structure and purpose. It provides foundational information about the organization, including its mission, values, and role as a non-profit, FQHC-led ACO. The manual also details the importance of provider participation and collaboration in achieving C3’s goals. Key sections include an introduction to C3’s programs, a summary of provider responsibilities, and essential contact information for support. This section serves as a starting point for understanding the framework and expectations within C3’s network.
3.2. Regulatory Requirements
The Provider Manual outlines regulatory requirements for participation in Community Care Cooperative (C3). Providers must comply with state and federal laws, including MassHealth regulations and HIPAA standards. The manual details requirements for documentation, billing, and patient confidentiality. It also covers C3’s obligations under the Affordable Care Act and the MassHealth ACO Program. Providers are expected to meet annual reporting and audit requirements to ensure compliance. Failure to adhere to these standards may result in penalties or termination from the network. The manual provides guidance on maintaining compliance and staying updated on regulatory changes.
3.3. Policies and Procedures
The Provider Manual details policies and procedures for C3 providers, ensuring alignment with organizational goals and regulatory standards. It includes guidelines for care coordination, patient referrals, and documentation practices. Providers are expected to adhere to policies regarding patient rights, confidentiality, and cultural competence. The manual also outlines procedures for reporting adverse events, managing grievances, and ensuring continuity of care. Additionally, it provides guidance on quality improvement initiatives and training requirements. Updates to policies and procedures are communicated regularly through provider bulletins and training sessions to ensure compliance and consistency in care delivery across the network.
Behavioral Health Services
Community Care Cooperative (C3) offers comprehensive behavioral health services, including Massachusetts Behavioral Health Partnership (MBHP) programs, therapy, and substance abuse treatment. We integrate these services with primary care and connect members to community-based resources for holistic support.
4.1. Massachusetts Behavioral Health Partnership (MBHP)
The Massachusetts Behavioral Health Partnership (MBHP) is a key contractor for MassHealth, overseeing behavioral health services. Through MBHP, Community Care Cooperative (C3) offers access to essential services, including therapy, substance abuse treatment, and mental health support. These services are designed to address the diverse needs of members, ensuring comprehensive care. C3 works closely with MBHP to integrate behavioral health services with primary care, promoting a holistic approach to health and wellness. This collaboration enhances accessibility and coordination, benefiting members across Massachusetts.
4.2. Integration with Primary Care
Community Care Cooperative (C3) emphasizes the integration of behavioral health services with primary care to provide holistic patient care. This approach ensures seamless coordination between physical and mental health services, reducing fragmentation and improving outcomes. C3’s primary care providers work closely with behavioral health specialists to address patient needs comprehensively. By embedding behavioral health services within primary care settings, C3 enhances accessibility and reduces stigma. This integrated model supports early identification and treatment of mental health and substance use disorders, fostering better overall health and wellness for members across Massachusetts.
4.3. Access to Behavioral Health Programs
Community Care Cooperative (C3) ensures access to comprehensive behavioral health programs through partnerships with Massachusetts Behavioral Health Partnership (MBHP) and local providers. Members can access services such as mental health counseling, substance use treatment, and crisis intervention. C3’s network includes Federally Qualified Health Centers (FQHCs) and community-based organizations, reducing barriers to care. Programs are designed to address diverse needs, including cultural sensitivity and stigma reduction. By integrating behavioral health with primary care, C3 improves accessibility and ensures timely interventions, enhancing overall well-being for its members across Massachusetts.
Grievance Process for Members
Members can file grievances via phone, mail, or in-person. C3 ensures a fair, member-focused resolution process to address concerns promptly and effectively.
5.1. Filing a Grievance
Members can file a grievance by contacting C3 via phone at 1-866-676-9226 (TTY: 711) or by mail at:
- Community Care Cooperative (C3)
- Attention: Member Advocates ― Grievances
- 75 Federal Street, 7th Floor
- Boston, MA 02110
Grievances can also be submitted in person during business hours. The process is designed to ensure members’ concerns are addressed fairly and efficiently, with a focus on resolving issues promptly and to the member’s satisfaction.
5.2. Contact Information
For assistance with grievances or general inquiries, members can contact Community Care Cooperative (C3) through multiple channels:
- Phone: 1-866-676-9226 (TTY: 711)
- Mail: 75 Federal Street, 7th Floor, Boston, MA 02110
- Hours: Monday ― Friday, 8am-5pm (EST)
C3’s member advocates are available to provide support and ensure members receive the necessary assistance. Members can also visit the Mass.gov website for additional resources and updates.
5.3. Resolution Process
Community Care Cooperative (C3) ensures a fair and efficient resolution process for member grievances. Upon receipt, grievances are reviewed and investigated promptly. Members receive written confirmation of the resolution, including any actions taken. If unresolved, members can appeal to MassHealth. C3’s Member Advocates work closely with all parties to address concerns and ensure satisfactory outcomes. The process is designed to be transparent, member-focused, and aligned with regulatory standards. C3 aims to resolve grievances within 30 days, ensuring continuity of care and member satisfaction throughout the process.
Expansion and Growth
Community Care Cooperative (C3) is expanding its value-based care programs in Massachusetts and Oregon through MSSP Enhanced Track participation and ACO Primary Care Flex Awards, aiming to enhance healthcare access and deliver high-quality, cost-effective care.
6.1. Value-Based Care Program Expansion
Community Care Cooperative (C3) is actively expanding its value-based care programs to enhance healthcare delivery in Massachusetts and Oregon. This expansion focuses on improving patient access to high-quality, cost-effective care while addressing population health needs. By leveraging innovative care models and partnerships, C3 aims to strengthen its network of FQHCs and community-based providers. The program emphasizes preventive care, chronic disease management, and coordination between primary and specialty services. This initiative aligns with C3’s mission to deliver equitable, patient-centered care, ensuring improved health outcomes for underserved populations and advancing the vision of a sustainable healthcare system.
6.2. MSSP Enhanced Track Participation
Community Care Cooperative (C3) has advanced its participation in the Medicare Shared Savings Program (MSSP) Enhanced Track, demonstrating its commitment to value-based care. This track requires greater financial accountability and offers higher potential savings for achieving quality and cost benchmarks. C3’s participation reflects its strategy to optimize care coordination, reduce healthcare costs, and improve patient outcomes. By aligning with MSSP goals, C3 strengthens its position as a leader in innovative, community-focused care, ensuring sustainable improvements in healthcare delivery across Massachusetts.
6.3. ACO Primary Care Flex Awards
Community Care Cooperative (C3) has received ACO Primary Care Flex Awards to enhance its primary care capabilities. These awards support C3’s mission to deliver high-quality, patient-centered care, particularly in underserved communities. The funding enables C3 to strengthen its network of FQHCs, improving access to preventive services, chronic disease management, and behavioral health integration. By focusing on value-based care, C3 aims to reduce healthcare disparities and improve population health outcomes. These awards underscore C3’s commitment to advancing primary care innovation and ensuring equitable healthcare access for all members.
Financial and Regulatory Compliance
Community Care Cooperative (C3) ensures financial and regulatory compliance as a 501(c)(3) non-profit, strictly adhering to MassHealth funding, DSRIP allocations, tax obligations under Chapter 62C, and annual progress reports.
7.1. Funding and Attribution
Community Care Cooperative (C3) receives funding primarily through MassHealth, including DSRIP allocations, to support care coordination, community partnerships, and health equity initiatives. Attribution of members is based on Medicaid claims data, ensuring alignment with care management programs. C3 also complies with financial reporting requirements, submitting annual progress reports to MassHealth. These reports detail program outcomes, financial performance, and adherence to regulatory standards. The organization prioritizes transparent stewardship of public funds, ensuring resources are allocated to improve healthcare access and quality for underserved populations across Massachusetts.
7.2. Tax Compliance and Reporting
Community Care Cooperative (C3) adheres to strict tax compliance and reporting standards as a 501(c)(3) non-profit organization. Annual financial reports and tax filings are submitted to ensure transparency and accountability. C3 complies with Massachusetts tax regulations under Chapter 62C and maintains audit-ready financial records. The organization also submits annual progress reports to MassHealth, detailing financial performance, tax compliance, and program outcomes. These reports are essential for maintaining funding and ensuring alignment with state and federal requirements. C3’s commitment to tax compliance underscores its mission to responsibly steward public and private resources for community health improvement.
7.3. Annual Progress Reports
Community Care Cooperative (C3) is required to submit annual progress reports to MassHealth, detailing its performance metrics, financial status, and program outcomes. These reports ensure accountability and transparency, highlighting achievements in quality improvement, cost savings, and member satisfaction. The reports also outline progress toward strategic goals, such as expanding value-based care and enhancing behavioral health services. Publicly available, these documents provide stakeholders with insights into C3’s operational effectiveness and its commitment to improving healthcare delivery in Massachusetts. The reports are essential for maintaining compliance with state and federal regulations governing ACOs.
Partnerships and Collaborations
Community Care Cooperative (C3) fosters strategic partnerships with FQHCs, the MassHealth ACO program, and community-based organizations to enhance care coordination and expand healthcare access.
8.1. Federally Qualified Health Centers (FQHCs)
Community Care Cooperative (C3) is a non-profit ACO led by 15 federally qualified health centers (FQHCs) in Massachusetts. These FQHCs provide comprehensive primary care services to underserved populations, ensuring access to affordable healthcare. As founding members, FQHCs govern C3, fostering a collaborative approach to improving health outcomes. Their expertise in delivering cost-effective, high-quality care aligns with C3’s mission to enhance care coordination and address social determinants of health. This partnership strengthens C3’s ability to serve vulnerable communities, ensuring equitable access to essential healthcare services across Massachusetts.
8.2. MassHealth ACO Program
The MassHealth ACO Program is a key initiative under the Executive Office of Health and Human Services, aiming to enhance care coordination and cost efficiency. Community Care Cooperative (C3) was established to participate in this program, focusing on improving health outcomes for MassHealth members. As the only ACO in Massachusetts led by FQHCs, C3 ensures access to comprehensive services, including primary care, behavioral health, and care management. The program emphasizes value-based care, aligning with C3’s mission to deliver high-quality, equitable healthcare to underserved populations across Massachusetts.
8.3. Community-Based Care Partnerships
Community Care Cooperative (C3) fosters strong partnerships with local organizations to enhance care delivery. By collaborating with FQHCs and community groups, C3 ensures access to essential services, including care management and behavioral health programs. These partnerships focus on addressing social determinants of health and improving health equity. Through shared resources and coordinated efforts, C3 strengthens community-based care, ensuring members receive comprehensive support. These collaborations are central to C3’s mission of delivering equitable, patient-centered care, ultimately improving health outcomes for underserved populations across Massachusetts.
Performance and Outcomes
Community Care Cooperative (C3) demonstrates strong performance through improved care coordination, high patient satisfaction scores, and cost efficiency. These outcomes highlight C3’s commitment to delivering effective, equitable care.
9.1. Quality Metrics and Improvement
Community Care Cooperative (C3) prioritizes quality metrics to enhance patient outcomes and care delivery. By focusing on preventive care, chronic disease management, and patient engagement, C3 has achieved significant improvements in key performance indicators. Regular audits and data analytics drive continuous improvement initiatives, ensuring adherence to national standards. C3’s efforts in reducing hospital readmissions and improving care coordination have been recognized, demonstrating its commitment to high-quality, patient-centered care. These initiatives underscore C3’s dedication to advancing healthcare excellence within Massachusetts communities.
9.2. Patient Satisfaction Scores
Community Care Cooperative (C3) consistently achieves high patient satisfaction scores, reflecting its commitment to patient-centered care. Surveys highlight strong performance in communication, accessibility, and cultural sensitivity. C3’s focus on integrated care and community-based services contributes to positive feedback. Patients appreciate the ease of accessing appointments and the responsiveness of care teams. C3 uses satisfaction data to identify areas for improvement, ensuring continuous enhancement of services. These efforts underscore C3’s dedication to delivering high-quality, patient-focused care across Massachusetts, aligning with its mission to improve health outcomes for diverse populations.
9.3. Cost Efficiency and Savings
Community Care Cooperative (C3) demonstrates strong cost efficiency through value-based care initiatives, achieving significant savings for patients and payers. By optimizing care coordination and reducing unnecessary hospitalizations, C3 minimizes healthcare costs while improving outcomes. Its focus on preventive care and early interventions further enhances cost savings. C3 also invests in data analytics to identify high-cost areas and implement targeted solutions. These strategies have resulted in measurable savings, enabling C3 to reinvest in community health programs and expand access to underserved populations, aligning with its mission to deliver affordable, high-quality care in Massachusetts.
Future Goals and Initiatives
C3 plans to expand its value-based care program, participate in the MSSP Enhanced Track, and pursue ACO Primary Care Flex Awards to improve community health outcomes in Massachusetts.
10.1. Enhancing Care Coordination
Community Care Cooperative (C3) aims to strengthen care coordination by integrating data systems and improving communication between providers. This initiative focuses on seamless transitions for patients, especially those with complex needs. By enhancing collaboration with community partners and expanding care management programs, C3 seeks to address social determinants of health and behavioral health needs. These efforts will ensure personalized, high-quality care delivery, reducing fragmentation and improving patient outcomes. C3 also plans to expand its care coordination services to better support underserved populations and foster a more holistic approach to healthcare in Massachusetts.
10.2. Expanding Behavioral Health Services
Community Care Cooperative (C3) is committed to expanding behavioral health services to address growing mental health needs in Massachusetts. By collaborating with the Massachusetts Behavioral Health Partnership (MBHP) and integrating primary care with behavioral health, C3 aims to improve access to essential services. This initiative includes enhancing outreach programs, increasing telehealth options, and addressing health-related social needs. Through the SHIFT-Care Challenge and other innovative programs, C3 is investing in sustainable solutions to reduce disparities and ensure equitable care. These efforts focus on underserved populations, leveraging partnerships with FQHCs and community-based organizations to deliver comprehensive support.
10.3. Increasing Community Engagement
Community Care Cooperative (C3) prioritizes increasing community engagement to foster stronger connections with the populations it serves. Through partnerships with local organizations and FQHCs, C3 aims to enhance outreach and education, ensuring members are aware of available resources. Programs focus on addressing social determinants of health and promoting health equity. By leveraging community-based care partnerships and innovative initiatives like the SHIFT-Care Challenge, C3 works to empower individuals and families. This approach emphasizes collaboration, cultural sensitivity, and patient-centered care, ultimately building trust and improving health outcomes for underserved communities across Massachusetts.