Tag: CCTP

What They Did: CBOs and the Community-based Care Transitions Program

by Anne Montgomery Now that the health care sector is focusing on social determinants of health (SDOH) in older adults and actively pursuing partnerships with community-based organizations (CBOs) to meet a surging demand for supportive services, it’s an excellent time to ask: What do we already know from key demonstration programs in this space? Some

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Assistant Secretary Greenlee Calls for Stronger Advocacy, Solutions, and “Community-Based Technology”

On April 26, Assistant Secretary for Aging Kathy Greenlee addressed the National Association of Area Agencies on Aging (n4a) at its spring policy conference. President Obama had just signed the Older Americans Act (OAA) reauthorization (P.L. 114-144) into law a week earlier—the culmination of a six-year effort. This is the major federal funding for the

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Readmissions Count: Should CMS Revise Its Calculations?

by Dr.  Joanne Lynn When community coalitions apply for funding from the Community-Based Care Transitions program of the Centers for Medicare and Medicaid (CMS), they have to show that they will reduce hospital readmissions by 20% and will save money for Medicare. Funding recipients will be held to those two outcomes in evaluating the contract.

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Reaching Rural Residents: Improving Care Transitions in Western New York State

The P2 Collaborative of Western New York [name was changed to Population Health Collaborative in 2017] represents a different spin on the Community-based Care Transitions Program (CCTP) model. It is unique in its focus on a very rural area of Western New York, and is unusual in that it is one of a few  community-based

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SAGE: Bridging the Divide between Acute Medical Care and Social Services in Northeast Ohio

By Dr. Kyle Allen and Susan Hazelett The Summa Health System/Area Agency on Aging, 10B/Geriatric Evaluation Project(SAGE) is a collaboration between an integrated health system and the local Area Agency on Aging which was begun in 1995. SAGE  provided the organizational structure to develop the resources and processes needed to effectively integrate geriatric medical services

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Early Days: Chicago-Based CCTP Program Describes The Work To Date

CJE SeniorLife, a community-based organization that serves some 18,000 older adults annually, is among the first cohort of recipients for  Section 3026 or  Community-Based Care Transition Program (CCTP) funding from the Centers for Medicare and Medicaid. One of seven early awardees, CJE will anchor a project that includes three large hospitals in Northern Chicago, as

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CMS Announced First Awards for CCTP Funding

CMS announced the first sites selected for the Community Based Care Transition Program. Please see the links below for the list of sites and an updated fact sheet. As noted above, we continue to accept applications and look forward to selecting additional sites in the near future. The following overview of the selected sites offers

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