Provision of Care Management. In accordance with Appendix K, the MCP shall assess new members using the standardized health risk assessment tool within 90 calendar days of enrollment for the purpose of risk stratification and to identify potential needs for care management.
Provision of Care Management. 2.5.2.1 Requirements for an Interdisciplinary Care Team. Every Enrollee shall have access to and input in the development of an ICT led by a Care Coordinator. The ICT will be person-centered, built on the Enrollee’s specific preferences and needs and with his or her input, delivering services with transparency, individualization, respect, linguistic and cultural competence, and dignity. ICT’s will:
Provision of Care Management. 5.11.1.1 Contractor shall offer Care Management through a Care Coordinator who participates in an Interdisciplinary Care Team for all medical, behavioral health and Covered Services under Service Package I and II, including assessment of the Enrollee’s clinical risks and needs, medication management, and health education on complex clinical conditions, as appropriate to the individual needs and preferences of the Enrollee.
Provision of Care Management. Contractor shall offer Care Management through a Care Coordinator who participates in an interdisciplinary care team for all medical, behavioral‐health, and Covered Services under service packages I and II, including assessment of the Enrollee’s clinical risks and needs, medication management, and health education on complex clinical conditions, as appropriate to the individual needs and preferences of the Enrollee. Contractor shall ensure that the Care Management services required by this Contract are provided to all Enrollees in NFs. These services may be provided by Nursing Facility Care Coordinators and supplemented by Contractor to fulfil the requirements of this Contract.
Provision of Care Management. Contractor shall provide Care Management to all Enrollees that accept or request it, through a Care Coordinator who participates in an Interdisciplinary Care Team (ICT). Care Management includes assessment of the Enrollee’s clinical risks and needs, medication management, and health education on complex clinical conditions, as appropriate to the individual needs and preferences of the Enrollee.
Provision of Care Management. In accordance with Appendix K, the MCP must assure that each member is in a care management arrangement where the MCP (or its delegate) or a patient-centered medical home (PCMH) is the designated primary care management entity. In the event ODM is unable to identify which members are assigned/attributed to a PCMH, the MCP will identify if the member has an existing relationship (i.e., attribution, assignment) with a patient centered medical home (PCMH) and, if not, connect the member to a PCMH, as applicable. There must be a clear delineation of roles and responsibilities between the MCP and other entities (PCMH, community partners, etc.) that are responsible for, or are contributing to, care management in order to assure no duplication of, or gaps in, services. Members under the age of 21 must be initially assigned to the intensive or high risk level until an assessment can be completed to confirm or adjust the initial risk level.
Provision of Care Management. In accordance with Appendix K, the MCP must ensure that each member is in a care management arrangement where the MCP (or its delegate) or a Comprehensive Primary Care (CPC) practice is the designated primary care management entity. In the event ODM is unable to identify which members are assigned to a CPC, the MCP will identify if the member has an existing relationship (i.e., attribution, assignment) with a CPC and, if not, connect the member to a CPC, as applicable. There must be a clear delineation of roles and responsibilities between the MCP and other entities (CPC, community partners, etc.) that are responsible for, or are contributing to, care management in order to ensure no duplication or gaps in services. Members under the age of 21 must be initially assigned to the intensive or high risk level until an assessment can be completed to confirm or adjust the initial risk level.
