11/14/24 Grand Rounds

Steven Bucchianeri, RPh, PharmD
Sr. Director Community Partners Program, Population Health

Erin Nahrgang, RN, CCM
Sr. Director Complex Care Management, Population Health

Henry Hernández, LMHC, CCM, MBA
Sr. Manager, Behavioral Health Care Management, WellSense

Through its health insurance plan WellSense (WS), Boston Medical Center and its partners provide MassHealth coverage to over 500K individuals through Accountable Care Organizations (ACOs) and Managed Care Organization (MCO). WS ACO and MCO members have access to a variety of behavioral health care management programs and supports ranging from complex care management to telephonic support. The programs work collaboratively to ensure WS ACO/MCO members receive the most appropriate level of programming to support each member’s plan of care. This session will provide an overview of the available programs and supports and how BMC providers can access them in support of their patients.

Learning Objectives:

1. Describe the value of care management interventions targeting behavioral health care and navigation.

2. Describe what supports are provided to a patient when enrolled in the Complex Care Management (CCM), BH Community Partners (CP), and WellSense BH Care Management programs.

3. Describe the process a provider would use to refer a WS ACO/MCO member to these programs.