Disease Management Programs Clause Samples
The Disease Management Programs clause establishes the requirements and procedures for implementing coordinated healthcare initiatives aimed at managing chronic diseases among covered individuals. Typically, this clause outlines the responsibilities of healthcare providers or insurers to offer education, monitoring, and support services for conditions such as diabetes, asthma, or heart disease. Its core practical function is to improve patient outcomes and reduce healthcare costs by ensuring systematic, proactive management of chronic illnesses.
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Disease Management Programs. HSD seeks to improve the health status of all individuals in the CoLTS population with specific diseases. Disease Management programs and Performance Measures are two of the tools that HSD has chosen to use to measure the CONTRACTOR’s ability to impact health outcomes. In that regard, the CONTRACTOR shall:
(1) improve its ability to manage chronic illnesses/diseases through Disease Management protocols in order to meet goals based on jointly established targets;
(2) provide comprehensive Disease Management for a minimum of two (2) chronic diseases using strategies consistent with nationally recognized Disease Management guidelines, such as those available through Agency of Healthcare Research and Quality’s (AHRQ), NQMC web site, or Disease Management Association of America. Examples of chronic diseases include but are not limited to: asthma, diabetes, hypertension, coronary artery disease, and COPD;
(3) submit cumulative data-driven measurements from each of its Disease Management programs with written analysis describing the effectiveness of its Disease Management interventions as well as any modifications implemented by the CONTRACTOR to improve its Disease Management performance. All disease management data submitted to HSD shall be New Mexico Medicaid-specific;
(4) submit to HSD by September 1st of the current contract year the CONTRACTOR’s Disease Management plan, which includes a program description, the overall program goals, measurable objectives, and targeted interventions. The CONTRACTOR shall also submit to HSD its methodology used to identify other diseases for potential Disease Management programs;
(5) submit HSD by August 30th of the following contract year a quantitative evaluation of the efficacy of the prior year’s Disease Management Program; and
(6) demonstrate consistent improvement in the overall Disease Management program goals annually or maintain mutually agreed upon level of performance with a report to HSD as set forth further in the Appendices.
Disease Management Programs. ▇▇▇▇▇ shall cooperate with the District in the development, achievement, and ongoing operation of disease management programs established by the District.
Disease Management Programs. The PPO offers programs focused on clinical health conditions including education and management. Participation in a PPO disease management/care management program may include coverage for certain services that would not otherwise be provided for under this Certificate.
Disease Management Programs. The Disease Management Program is a collaborative program that assesses the health needs of Members with a chronic condition and provides education, counseling, and information designed to increase the Member’s self-management of this condition. The goals of Keystone Health Plan Central’s Disease Management Program are to maintain and improve the overall health status of Members with specific diseases through the provision of comprehensive education, monitoring and support for healthy self-management techniques. The Disease Management Program is especially beneficial for Members who have complex health care needs or who require additional assistance and support. Participation in Keystone Health Plan Central’s Disease Management Program is voluntary and involves no additional cost to our Members.
Disease Management Programs. Participation by a Covered Person in a Disease Management Program may be required. Participation will be at the discretion of OTIP.
Disease Management Programs. PPM agrees and shall require PPM Physicians to agree to participate in HUMANA's Disease/Case Management and Transplant Management Programs as they are developed and implemented. The cost of such programs shall be expensed against the Part B Funds.