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Commonwealth Care Alliance

Delivers integrated, person-centered health plans

Overview

Commonwealth Care Alliance (CCA) provides health plans and care delivery programs tailored for people with the most significant health needs in Massachusetts. It coordinates services across its own staff, a network of healthcare providers, and community organizations to deliver comprehensive, integrated, and person-centered care. Unlike traditional insurers, CCA focuses on high-need individuals by aligning medical, social, and community supports through its care delivery model. The company’s goal is to improve health outcomes and quality of life for its members by tightly coordinating services and resources around each person’s needs.

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About Commonwealth Care Alliance

Simplify's Rating
Why Commonwealth Care Alliance is rated
B-
Rated B on Competitive Edge
Rated B on Growth Potential
Rated C on Differentiation

Industries

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Company Size

1,001-5,000

Company Stage

Grant

Total Funding

$1.8M

Headquarters

Boston, Massachusetts

Founded

2003

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Simplify's Take

What believers are saying

  • CareSource completed acquisition April 9, 2025, extending CCA’s financial runway.
  • June 26, 2026 CareSource operational support improves billing, portals, and payment infrastructure.
  • CCA appointed Pablo Hernandez CMO on August 6, 2026, strengthening clinical leadership.

What critics are saying

  • The April 2025 DOJ settlement for Reliance HMO anti-kickback conduct damaged compliance credibility.
  • CCA’s workforce fell to 1,629 by March 2026, signaling ongoing integration strain.
  • June 2026 CareSource systems migration risks claims disruption and member/provider churn.

What makes Commonwealth Care Alliance unique

  • CCA specializes in Medicare-Medicaid dual eligibles with disability-competent care and coordination.
  • Its 2025 CareSource acquisition preserved Senior Care Options and One Care brands.
  • CCA’s 2024 Beth Israel Lahey expansion added over 7,000 practitioners across Eastern Massachusetts.

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Funding

Total Funding

$1.8M

Above

Industry Average

Funded Over

1 Rounds

Grant funding comparison data is currently unavailable. We're working to provide this information soon!
Grant Funding Comparison Coming Soon

Benefits

  • Remote Work Options
  • Flexible Work Hours

Growth & Insights and Company News

Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%
WOWK-TV
Oct 9th, 2026
Commonwealth Care Alliance(R) Senior Care Options plan achieves 4.5 Star Quality rating from the centers for Medicare and Medicaid services.

Commonwealth Care Alliance(R) Senior Care Options plan achieves 4.5 Star Quality rating from the centers for Medicare and Medicaid services. Oct 09, 2026, 12:00 PM ET CCA health plan ranks among top 16% of plans nationally in high-quality, coordinated care BOSTON, Oct. 9, 2026 /PRNewswire/ - Commonwealth Care Alliance (CCA), a mission-driven healthcare services organization offering innovative health plans and care delivery programs designed for individuals with the most significant needs, earned 4.5 out of 5 stars in CMS' 2027 Star Quality Ratings, up from 4 stars last year. The rating is for CCA's Massachusetts Senior Care Options (SCO) plan, an HMO designed to serve the unique needs of individuals aged 65 and older who are dually eligible for Medicare and Medicaid. CMS Star Ratings measure health plan performance across several categories, including clinical care, health outcomes, patient experience and customer service. CMS' quality ratings system is designed to help consumers, their families, and caregivers easily compare the quality of the plans available to them and empower them to make the best health care decisions. For Star Quality rating year 2027, CMS rated 508 Medicare Advantage plans on a scale of 1 to 5 stars. Nationally, the average 2027 Star rating is 3.99 stars. Only 37% of MAPD contracts, including CCA, earned a score of 4 stars or higher, and ratings are based on up to 40 unique quality and performance measures. CCA's 4.5-Star Rating for 2027 continues the organization's record of strong performance. "Advancing from 4 to 4.5 stars reflects the discipline and compassion of our teams and the progress we have made strengthening quality, accountability and operational performance," said John Koehn, President of Commonwealth Care Alliance and Massachusetts Market President at CareSource. "This achievement tangibly demonstrates our progress towards creating better, more consistent health outcomes for our members. I am proud of what our teams have accomplished, and we're committed to building on this momentum." Over the past year, as CCA completed its integration into CareSource systems, the SCO plan posted gains across several Star Ratings measures. Scores increased for operational and administrative performance, while the plan earned high marks for member experience, preventive screenings, chronic condition management, behavioral health, and medication adherence. CCA's SCO plan serves more than 19,000 individuals, including a high proportion of members with complex needs and chronic conditions. With the support of CCA along with our community and provider partners, the vast majority of our SCO members who are nursing home certifiable, live safely and independently at home. CCA's One Care plans, which serve individuals ages 21 to 64 who are dually eligible for MassHealth and Medicare, earned a 4-star parent organization rating for 2027. Both One Care and SCO provide comprehensive, no-cost coverage designed to help members stay healthy and live safely and independently at home, with benefits including dental services, specialty medical care and preventive care. About Commonwealth Care Alliance Commonwealth Care Alliance(R)(CCA) is a mission-driven healthcare services organization that offers innovative health plans and care delivery programs designed for individuals with the most significant needs. Through our flagship Senior Care Options (SCO) and One Care plans in Massachusetts, CCA delivers comprehensive, integrated, and person-centered care by coordinating the services of local staff, provider partners, and community-based organizations to meet the unique needs of each individual we serve. As part of the CareSource family of companies, CCA is strengthened by expanded resources and shared expertise that support its mission to deliver high-quality, person-centered care. SOURCE CCA NOTE: This content is not written by or endorsed by "WOWK", its advertisers, or Nexstar Media Inc.

PR Newswire
Aug 6th, 2026
Commonwealth Care Alliance names Dr Pablo Hernandez as VP and chief medical officer

Commonwealth Care Alliance has appointed Dr Pablo Hernandez as Vice President and Chief Medical Officer. The Massachusetts-based healthcare services organisation serves individuals with complex needs through integrated health plans and care delivery programmes. Dr Hernandez brings over 20 years of experience caring for dual-eligible individuals across community health centers, academic medicine, and managed care plans. Most recently, he served as Chief Medical Officer at Edward M. Kennedy Community Health Center in Worcester, Massachusetts, overseeing clinical operations, quality, and population health. He previously held the position of Senior Medical Director at Boston Medical Center HealthNet Plan, where he managed the Senior Care Options product. Dr Hernandez holds a Master of Science in Health Care Management from Harvard School of Public Health and completed his Family Medicine residency at the University of Connecticut.

Health Care News
Mar 31st, 2026
Emily Bailey appointed commissioner of Massachusetts Department of Mental Health.

Emily Bailey appointed commissioner of Massachusetts Department of Mental Health. BOSTON - Massachusetts Secretary of Health and Human Services Dr. Kiame Mahaniah announced that Emily Bailey has been appointed commissioner of the Department of Mental Health (DMH) effective April 12. Bailey brings more than 20 years of leadership experience across state government, Medicaid, Medicare, commercial health plans, and community-based care. She has dedicated her career to transforming complex systems to deliver integrated, person-centered mental healthcare for individuals with mental health needs, disabilities, and social risk factors. Beth Lucas, who has served as acting commissioner since October, is returning to her prior role as deputy commissioner for Mental Health Services, where she will continue to oversee the DMH community service system. "Emily's extensive experience as a behavioral health leader combined with her deep compassion for our neighbors served by the Department of Mental Health will position the agency well to meet this moment of rising need for DMH's services," Mahaniah said. "Emily will further DMH's mission to support the continuum of mental healthcare needs across our state, from acute care for our state's most vulnerable children and adults with complex mental health needs, to upstream mental wellness and prevention that is so important, particularly for our young people." Bailey most recently served as senior vice president at Commonwealth Care Alliance, where she led clinical strategy, operations, and innovation for populations with complex medical and behavioral health needs. Her prior public sector leadership includes serving as chief of Behavioral Health at MassHealth, where she oversaw statewide behavioral health policy, program design, and implementation. She played a central role in major system reforms, including the launch of the Community Behavioral Health Centers and expansion of community-based crisis services. Bailey has also held executive roles at Point32Health and Carelon, where she led behavioral health strategy, population health initiatives, and cross-sector partnerships focused on improving outcomes, treatment access, and quality. Throughout her career, she has been a champion for reducing stigma, improving access to treatment, and improving the experience of interfacing with the mental health system. She is known for her collaborative leadership style, operational rigor, and ability to bring together state agencies, providers, advocates, and communities to drive meaningful, sustainable change. She holds a master of social work degree. "It is a profound honor to join the Department of Mental Health at a moment when the need for accessible, equitable mental healthcare has never been clearer," Bailey said." The department's dedicated staff and agency partners have driven meaningful progress in strengthening our behavioral health system, and I am committed to building on that work with urgency, partnership, and collaboration. I look forward to working alongside stakeholders across the Commonwealth to expand services, reduce barriers, and support individuals and families in every community."

The Business Journals
Apr 9th, 2025
Commonwealth Care Alliance Acquired by Ohio Company

Commonwealth Care Alliance has been acquired by an Ohio company. The acquisition is intended to ensure long-term sustainability for the insurer, which serves Massachusetts residents with complex care needs.

GlobeNewswire
Apr 9th, 2025
CareSource Acquires Commonwealth Care Alliance

CareSource, a nonprofit managed care organization, has completed its acquisition of Commonwealth Care Alliance (CCA), a nonprofit health care services organization in Massachusetts. CCA will continue operating its Senior Care Options and One Care plans under the CareSource Family of Brands. This partnership aims to enhance care for Massachusetts residents with complex health needs. CCA insures nearly 50,000 residents who are dually eligible for Medicare and Medicaid.

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