CCTP Partners: Round 1 Site Summaries

The Community -based Care Transitions Program (CCTP) is a five-year program created by the Affordable Care Act. Participants sign two-year program agreements with CMS, with the option to renew each year for the remainder of the program, based on their success. As of the date of this announcement, CMS continues to accept applications and approve participants on a rolling basis as long as funds remain available.

The following is information on the Round 1 (Nov 18, 2011) CCTP partner sites.


Maricopa County, Arizona: The Area Agency on Aging, Region One
Serving Maricopa County in Arizona, in partnership with John C. Lincoln North Mountain Hospital, West Valley Hospital, Scottsdale Healthcare Osborn Medical Center, John C. Lincoln Deer Valley Hospital; APIPA, a Medicaid Acute Care Plan that serves dually-enrolled Medicare fee-for-service beneficiaries; and Sunwest Pharmacy.
Maricopa County, Arizona Detailed Summary (PDF)



Atlanta Community-Based Care Transitions Program (Atlanta CCTP)
A collaborative partnership serving ten counties in the Atlanta region, including the Atlanta Regional Commission (an Area Agency on Aging), and six urban area hospitals: Emory University Hospital Midtown, Gwinnett Medical Center, Piedmont Hospital, Southern Regional Hospital, WellStar Cobb Hospital and WellStar Kennestone Hospital.
Atlanta CCTP Detailed Summary (PDF)



Council for Jewish Elderly (“CJE SeniorLife”) in Chicago, IL
Partnering with Northwestern Memorial, Saint Joseph Hospital, and Saint Francis Hospital and working closely with Area Agencies on Aging in Chicago and suburbs, local Care Coordination Units (CCUs), and Illinois’ Quality Improvement Organization, IFMC.
CJE SeniorLife Detailed Summary (PDF)



The Southern Maine Agency on Aging/Aging and Disability Resource Center (SMAA/ADRC)
Serving five counties in southern and mid-coast Maine in partnership with the Maine Medical Center Physician-Hospital Organization and five MaineHealth hospitals: Southern Maine Medical Center, Maine Medical Center, Mid-Coast Hospital, Miles Hospital, and PenBay Medical Center.
SMAA/ADRC Detailed Summary (PDF)


Massachusetts / New Hampshire

Elder Services of the Merrimack Valley, Inc.
The Merrimack Valley, Inc., in partnership with Anna Jacques Hospital, Saints Medical Center, Holy Family Hospital, Lawrence General Hospital, and Merrimack Valley Hospital, provides care transitions services to Medicare beneficiaries who are at increased risk for readmission residing in 23 cities/towns in the Merrimack Valley of Massachusetts and ten bordering cities/towns in southern New Hampshire.
Merrimack Valley of Massachusetts and Southern New Hampshire (PDF)



Akron/Canton, Ohio Area Agency on Aging (A/C AAA)
Working in partnership with 10 acute care hospitals located within, or geographically contiguous to, the A/C AAA service area in Ohio: Affinity Hospital, Aultman Hospital, and Mercy Medical Center in Stark County; Akron General Medical Center, Summa Akron City Hospital, Summa Saint Thomas Hospital, Summa Barberton Hospital, and Summa Western Reserve Hospital in Summit County; Robinson Memorial Hospital in Portage County; and Summa Wadsworth Rittman Hospital in Medina County.
A/C AAA Detailed Summary (PDF)


Ohio / Kentucky / Indiana

Southwest Ohio Community Care Transitions Collaborative
Serving the Cincinnati Metropolitan Statistical Area and surrounding counties in Kentucky, Indiana, and Ohio, including the Council on Aging of Southwestern Ohio, the Greater Cincinnati Health Council, HealthBridge, Health Care Access Now, Healthcare Improvement Collaborative, Hamilton County Mental Health and Recovery Services Board, Clinton Memorial Hospital, Jewish Hospital, Mercy Hospital Fairfield, The Christ Hospital, and UC Health University Hospital.
Southwest Ohio Community Care Transitions Collaborative (PDF)