Care Management and Care Coordination Sample Clauses

Care Management and Care Coordination. 1. Care Needs Screening Report Quarterly report of Member screening results, including Healthy Opportunity & Care Needs Screening of Members. Quarterly
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Care Management and Care Coordination. $62.50 per contact not provided per Member (i.e., failure to have two of the required contacts for a Member would result in a $125 payment)
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Care Management and Care Coordination. $62.50 per occurrence per Member
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Care Management and Care Coordination. $500 per occurrence
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Care Management and Care Coordination. 6.1 Integrated Team-Based Care DVHA’s goal is to achieve integrated team-based care for all Attributed Members with complex needs who need services from multiple provider types and who would benefit from strong communication and collaboration between those providers. Members often seek care from a wide spectrum of health and human services providers to support comprehensive treatment of mental health conditions, substance use disorders, other health conditions, social determinant of health needs, and conditions requiring long-term services and supports. Contractor shall develop, implement, support, monitor, and evaluate a Care Model that is Member-directed, strengths-based, and responsive to the needs of Attributed Members. Contractor shall participate in activities to further align and improve care integration across the Medicaid benefit, as directed by DVHA. For attributed members who receive Medicaid-funded case management or care coordination, Contractor shall coordinate the provision of care management and care coordination to ensure services are supplementary and not duplicative. Contractor shall maintain procedures for transitioning Members to or from other care coordination entities or programs, and for graduating members from Contractor’s care coordination program. These procedures shall ensure that care team participants’ work together to facilitate a smooth transition of tasks and responsibilities between care coordination programs and staff. Contractor’s Care Model shall be inclusive of case managers, care coordinators, and other relevant staff from the AHS and community organizations delivering Medicaid funded health care, home- and community-based services, and long-term services and supports. Contractor shall develop and maintain collaborative relationships with State of Vermont agencies, departments, and programs in support of its Care Model activities, including the AHS; Blueprint for Health; Vermont Chronic Care Initiative (VCCI); Department of Disabilities, Aging, and Independent Living; Department of Mental Health (DMH); Vermont Department of Health (VDH); and VDH’s Division of Alcohol and Drug Abuse Programs (ADAP).
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Care Management and Care Coordination. 6.1 Integrated Team-Based Care DVHA’s goals are to achieve integrated team-based care that is person-centered for all Members with complex needs who need services from multiple provider types and who would benefit from strong communication and collaboration between those providers, and to support high-functioning Complex Care Ecosystems within each HSA. Members often seek care from a wide spectrum of health and human services providers to support comprehensive treatment of mental health conditions, substance use disorders, other health conditions, social determinant of health needs, and conditions requiring long-term services and supports. Integrated team-based care helps to ensure optimal care management and care coordination for those members. High-functioning Complex Care Ecosystems support integrated team-based care and the Care Model. Contractor shall continue to implement, support, monitor, and evaluate a Care Model that is Member-directed, strengths-based, and responsive to the needs of Attributed Members. Contractor shall participate in activities to further align and improve care integration across the Medicaid benefit, as directed by DVHA. If DVHA conducts assessments of the current state of integrated team-based care and Complex Care Ecosystems, refines approaches to integrated team-based care and Complex Care Ecosystems, or provides forums and trainings to enhance design and implementation of identified approaches, Contractor shall participate in such activities, including attending meetings, reviewing and providing written feedback on approaches and documents, and providing in-kind support (e.g., expertise, faculty) for training and education as requested by DVHA. For attributed members who receive Medicaid-funded case management or care coordination, Contractor shall coordinate the provision of care management and care coordination to ensure services are supplementary and not duplicative. Contractor shall maintain procedures for transitioning Members to or from other care coordination entities or programs, and for graduating members from Contractor’s care coordination program. To the extent that an Attributed Member has needs that can be addressed by ongoing care coordination, but no longer requires intensive care team support, Contractor will ensure that policies and procedures are in place to establish a long-term care coordination relationship and monitor evolving needs of the Member. These procedures shall ensure that care team participan...
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Care Management and Care Coordination 
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Related to Care Management and Care Coordination

  • Project Management and Coordination The Engineer shall coordinate all subconsultant activity to include quality of and consistency of work and administration of the invoices and monthly progress reports. The Engineer shall coordinate with necessary local entities.

  • Care Coordination MCOs must ensure care coordination is provided to Members with a substance use disorder. MCOs must work with providers, facilities, and Members to coordinate care for Members with a substance use disorder and to ensure Members have access to the full continuum of Covered Services (including without limitation assessment, detoxification, residential treatment, outpatient services, and medication therapy) as Medically Necessary and appropriate. MCOs must also coordinate services with the DSHS, DFPS, and their designees for Members requiring Non-Capitated Services. Non-Capitated Services includes, without limitation, services that are not available for coverage under the Contract, State Plan or Waiver that are available under the Federal Substance Abuse and Prevention and Treatment block grant when provided by a DSHS-funded provider or covered by the DFPS under direct contract with a treatment provider. MCOs must work with DSHS, DFPS, and providers to ensure payment for Covered Services is available to Out-of-Network Providers who also provide related Non-capitated Services when the Covered Services are not available through Network Providers.

  • Program Management 1.1.01 Implement and operate an Immunization Program as a Responsible Entity

  • Cooperation and Coordination The Parties acknowledge and agree that it is their mutual objective and intent to minimize, to the extent feasible and legal, taxes payable with respect to their collaborative efforts under this Agreement and that they shall use all commercially reasonable efforts to cooperate and coordinate with each other to achieve such objective.

  • Care Management The Contractor’s protocol for referring members to care management shall be reviewed by OMPP and shall be based on identification through the health needs screening or when the claims history suggests need for intervention. In addition to population-based disease management educational materials and reminders, these members should receive more intensive services. Members with newly diagnosed conditions, increasing health services or emergency services utilization, evidence of pharmacy non-compliance for chronic conditions and identification of special health care needs should be strongly considered for case management. Care management services include direct consumer contacts in order to assist members with scheduling, location of specialists and specialty services, transportation needs, 24-Hour Nurse Line, general preventive (e.g. mammography) and disease specific reminders (e.g. Xxx X0X), pharmacy refill reminders, tobacco cessation and education regarding use of primary care and emergency services. The Contractor shall make every effort to contact members in care management telephonically. Materials should also be delivered through postal and electronic direct-to-consumer contacts, as well as web-based education materials inclusive of clinical practice guidelines. Materials shall be developed at the fifth grade reading level. All members with the conditions of interest shall receive materials no less than quarterly. The Contractor shall document the number of persons with conditions of interest, outbound telephone calls, telephone contacts, category of intervention, intervention delivered, mailings and website hits. Care management shall be coordinated with the Right Choices Program for members qualifying for the Right Choices Program. However, the Right Choices Program is not a replacement for care management.

  • Project Management Plan 1 3.4.1 Developer is responsible for all quality assurance and quality control 2 activities necessary to manage the Work, including the Utility Adjustment Work.

  • Construction Management Services a. A-E may be required to review and recommend approval of submittals, shop drawings, Request for Information (RFI) and/or calculations for temporary structures such as trench shoring, false work and other temporary structural forms.

  • LABOUR MANAGEMENT RELATIONS 30.01 A Labour/Management Relations Committee shall be appointed, consisting of a maximum of two (2) Shop Stewards from the Union, and a maximum of two (2) representatives from the Co-operative. The full-time Union Representative may also attend these meetings from time to time. The Committee shall meet at the request of either party, for the purpose of discussing matters of mutual concern. Time spent by bargaining unit employees in carrying out the functions of this Committee shall be considered as time worked and shall be paid for by the Co-operative. The Committee shall not have jurisdiction to interpret and/or amend the Collective Agreement.

  • Information Management Information and Records

  • Coordination The Parties shall confer regularly to coordinate the planning, scheduling and performance of preventive and corrective maintenance on the Large Generating Facility and the Interconnection Facilities.

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