Common use of Network Adequacy Analysis Clause in Contracts

Network Adequacy Analysis. Contractor shall analyze the geographic distribution of the Provider network on a quarterly basis. Contractor shall also monitor other network adequacy indicators, such as Enrollee and Provider complaints related to access; call center requests from Enrollees, Providers, advocates and external organizations for help with access; and the percentage of completely open PCP panels versus percentage open only to existing patients. Contractor shall generate geographical distribution tables and maps to plot Enrollee and Affiliated Provider locations by zip code and analyze the information, considering the prevalent modes of transportation available to Enrollees, Enrollees’ ability to travel, and Enrollees’ ability to be in an office setting. When material gaps in the Contracting Area are identified, Contractor will within five (5) Business Days develop and implement a recruitment strategy to fill the gaps and immediately thereafter submit its strategy and proposed timeline to the Department.

Network Adequacy Analysis. Contractor shall analyze the geographic distribution of the Provider network Network and provide the results of this analysis to the Department on a quarterly basis. Contractor shall also monitor other network adequacy indicators, such as Enrollee and Provider complaints Complaints related to access; call center requests from Enrollees, Providers, advocates advocates, and external organizations for help with access; and the percentage of completely open PCP panels versus the percentage open only to existing patients. Contractor shall generate geographical geographic distribution tables and maps to plot Enrollee and Affiliated Network Provider locations by zip code and analyze the information, considering the prevalent modes of transportation available to Enrollees, Enrollees’ ability to travel, and Enrollees’ ability to be in an office setting. When material gaps in the Contracting Area are identified, Contractor will shall within five (5) Business Days develop and implement a recruitment strategy to fill the gaps and immediately thereafter submit its strategy and proposed timeline to the Department.