Disease Management. The CONTRACTOR shall provide DM strategies to Members with identified chronic conditions as part of its Care Coordination processes and activities. The CONTRACTOR’s DM strategies must include at a minimum population identification/stratification, collaborative practice models, self-management education, evidence-based practice guidelines, process and outcomes measurements and internal quality improvement processes. The CONTRACTOR shall improve its ability to manage chronic illnesses/diseases/conditions through DM protocols. The CONTRACTOR shall: Participate in DM projects annually; and Provide comprehensive DM for a minimum of two (2) chronic disease states, one (1) applicable/relevant to the Adult population and one (1) to the pediatric population, using strategies consistent with nationally recognized DM guidelines, such as those available through the Agency for Healthcare Research and Quality (AHRQ), the National Quality Measures Clearinghouse (NQMC), or the Care Continuum Alliance). The CONTRACTOR's Care Coordination program description must describe the CONTRACTOR’s DM strategies, including, at a minimum, the CONTRACTOR’s approach to population identification/stratification, collaborative practice models, Member self-management education, evidence-based practice guidelines, process and outcomes measurements, and internal quality improvement processes.
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Sources: Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement
Disease Management. The CONTRACTOR shall provide DM strategies to Members with identified chronic conditions as part of its Care Coordination processes and activities. The CONTRACTOR’s DM strategies must include at a minimum population identification/stratification, collaborative practice models, self-management education, evidence-based practice guidelines, process and outcomes measurements and internal quality improvement processes. The CONTRACTOR shall improve its ability to manage chronic illnesses/diseases/conditions through DM protocols. The CONTRACTOR shall: Participate in DM projects annually; and Provide comprehensive DM for a minimum of two (2) chronic disease states, one (1) applicable/relevant to the Adult population and one (1) to the pediatric population, using strategies consistent with nationally recognized DM guidelines, such as those available through the Agency for Healthcare Research and Quality (AHRQ), the National Quality Measures Clearinghouse (NQMC), or the Care Continuum Alliance). The CONTRACTOR's Care Coordination program description must describe the CONTRACTOR’s DM strategies, including, at a minimum, the CONTRACTORContractor’s approach to population identification/stratification, collaborative practice models, Member self-management education, evidence-based practice guidelines, process and outcomes measurements, and internal quality improvement processes.
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