Disease Management Program Clause Samples
A Disease Management Program clause outlines the requirements and procedures for managing chronic or specific diseases within a healthcare or insurance context. It typically details the responsibilities of the parties involved, such as providing access to educational resources, coordinating care, or monitoring patient compliance with treatment plans. By establishing clear protocols and expectations, this clause aims to improve health outcomes, control costs, and ensure consistent care for individuals with targeted health conditions.
Disease Management Program. Contractor is responsible for initiating and maintaining a disease management program. Contractor shall determine the program’s targeted disease conditions and implement a system to identify and encourage Members to participate.
Disease Management Program. The Disease Management Program 13 currently known as Blue Health Connection shall be included under the 14 State Health Plan as a covered benefit on a voluntary basis.
Disease Management Program. (DM) means a program that employs a set of interventions designed to improve the health of individuals, especially those with Chronic Health Conditions. Disease Management Program services include: (i) a population identification process; (ii) use and promotion of evidence-based guidelines; (iii) use of collaborative practice models to include Physician and support service Providers; (iv) Enrollee self-management education (includes primary prevention, behavioral modification, and compliance surveillance); (v) Care Management; (vi) process and outcome measurement, evaluation and management; and (vii) routine reporting/feedback loop (includes communication with the Enrollee, Physician, ancillary Providers and practice profiling). A Disease Management Program may be a part of a Care Management program.
Disease Management Program. A program that employs a set of interventions designed to improve the health of individuals, especially those with Chronic Health Conditions. Disease Management Program services include: (i) a population identification process; (ii) use and promotion of evidence-based guidelines; (iii) use of collaborative practice models to include Physician and support service Providers; (iv) Participant self-management education (includes primary prevention, behavioral modification, and compliance surveillance); (v) Care Management; (vi) process and outcome measurement, evaluation, and management; and (vii) routine reporting/feedback loop (includes communication with the Participant, Physician, ancillary Providers and practice profiling). A Disease Management Program may be a part of a Care Management program.
Disease Management Program a. Disease management programs provided by the Managed Care Plan shall address co-morbid conditions and consider the whole health of the enrollee.
b. Disease Management programs provided by the Managed Care Plan shall include, but are not limited to, the following components:
(1) Education based on the enrollee assessment of health risks and chronic conditions;
(2) Symptom management including addressing needs such as working with the enrollee on health goals;
(3) Emotional issues of the caregiver;
(4) Behavioral management issues of the enrollee;
(5) Communicating effectively with providers; and
(6) Medication management, including the review of medications that an enrollee is currently taking to ensure that the enrollee does not suffer adverse effects or interactions from contra-indicated medications.
c. The Managed Care Plan shall have policies and procedures regarding disease management programs provided that include the following:
Disease Management Program. Mandatory participation in program involving counseling by qualified RNs and Registered Dietician Advisors. This includes targeted health educational materials.
Disease Management Program. Mandatory participation in program involving counseling by qualified RNs and Registered Dietician Advisors. This includes targeted health education materials. One of the fundamental purposes of the Council is to afford the City and the Union a vehicle whereby both parties can assess the health care benefits program, with a focus on cost containment and efficient delivery of services. The parties shall each appoint two (2) representatives to the Council, which body shall thereafter appoint a Chairperson and Secretary. The Council shall, at a minimum, conduct quarterly meetings and shall be governed in the conduct of its affairs by ▇▇▇▇▇▇▇ Rules of Order (Revised edition).The representatives of the union shall have the unlimited right to obtain any and all documents, reports, memoranda or other information pertaining to the City's health care benefits program, including any and all financial records or payment records, which pertains to the Union. However, no confidential medical or other similar information shall be released to any Health Care Council member. The City agrees to provide any such data on request, and shall direct its health care benefits program administrator to fully cooperate with the Union's representatives and supply whatever data shall be requested from the program administrator. The Council shall appoint a Certified Public Accountant (CPA) to conduct an annual audit of the books, records and other pertinent data of the City and the health care benefits administrator. The cost and expenses of the CPA shall be paid by the City. In order to qualify for appointment, the CPA shall not have any other affiliation with the City or the Union. The CPA shall certify the actual annual cost of the health care benefits program to the Council, and shall fix the actual annual cost of the program in conformance with the criteria and procedures set forth above. No increase in co-payment amounts shall be affected until the CPA shall have certified the actual annual cost, as aforesaid. It is recognized that the City may enter into similar health care benefits programs with the bargaining representatives of other City employees. In such event, the Union agrees to consider joining a Unified Health Care Council (Unified Council), which may have the same functions, duties, and powers as set forth herein. The terms and conditions of the Union's participation in such Unified Council shall be subject to negotiation between the parties hereto.
Disease Management Program. Active officers and spouses who participate in a disease management program involving counseling by qualified RNs receive $100 (each) upon completion of four (4) sessions.
Disease Management Program. The Disease Management Program currently
Disease Management Program. The Disease Management Program currently 5 known as Blue Health Connection shall be included under the State Health Plan 6 as a covered benefit on a voluntary basis.