Integration of Care. This component of the evaluation must test the following hypotheses as they relate to both populations affected by the integration projects:
Integration of Care. Section 6.2.I is hereby amended by deleting it in its entirety and replacing it with the following:- “During Contract Year 2018, the Contractor shall partner with EOHHS to develop and execute a transition plan for MBHP members including but not limited to ICMP and PBCM Members who are identified by EOHHS for future enrollment in an ACO or CP. This plan shall include but not be limited to, Member-specific transitional “handoff” meetings between MBHP (including ICMP/PBCM members) and ACOs or CPs.”
Integration of Care. A. Project case managers are responsible for long-term care planning and at least annual assessments, for developing and carrying out strategies to coordinate and integrate the delivery of all acute and long-term care services to enrollees.
Integration of Care. Section 6.2.A is hereby amended by deleting it in its entirety and replacing it with the following language:
Integration of Care. Coordinated and unified treatment of health concerns across the physical and behavioral health spectrum.
Integration of Care. 1. Section 6.2.H is hereby amended by deleting it in its entirety and replacing it with the following:
Integration of Care. A. Project case managers are responsible for long-term care planning and for developing and carrying out strategies to coordinate and integrate the delivery of all acute and long-term care services to enrollees. B. For those persons enrolled in the contractor's Medicare+Choice plan (where applicable), the contractor must have protocols to ensure that all acute care services and services are coordinated. The enrollee's case manager must coordinate with the primary care physician, as well as the enrollee or other appropriate person, in the development of acute and long-term care plans. The contractor must ensure that all subcontractors, delivering services covered by the contract, agree to cooperate with the goal of an integrated and coordinated service delivery system for the enrollee. C. When contract enrollees elect to remain in the Medicare fee-for-service system, the contractor must establish protocols to ensure that services are coordinated to the maximum extent feasible. The case manager must actively pursue coordination with the enrollee's primary care physician and other care providers. Attachment I- 32 of 55 Contract No. 0000-0000-00
