Examples of ACO Program in a sentence
ACO Program obligations for the last Performance Year of participation, such as quality reporting, obligations for Shared Risk and opportunities for Shared Savings will survive termination.
Performance years (PYs) for the State’s ACO Program (i.e., the time periods which the State will use to calculate cost and quality accountability for ACOs) align with the calendar year (January 1 to December 31), and are thus offset from the State’s demonstration years by 6 months.The State will disburse DSRIP funding to ACOs using six “Budget Periods” (BPs) that align with ACO performance years.
To the extent a notice requirement in an ACO Program Addendum conflicts with or is more stringent than the notice requirements below, the shorter of the timeframes shall apply.
Participant and Preferred Provider will, consistent with any limitation arising from 42 CFR Part II, cooperate in connecting its information systems to ACO, or ACO’s designee, in order to facilitate the exchange of clinical and cost related data in furtherance of the requirements of the applicable ACO Program.
In the event of any conflict between this Agreement and an ACO Program Addendum, the terms of the ACO Program Addendum shall control.
ACO has entered into an agreement with DVHA through which the ACO will participate in the Vermont Medicaid Next Generation Model (the “Program”), an alternative payment and population health management program with Medicaid, as described in Vermont Medicaid Next Generation Participation Agreement that will be available on the ACO Provider Portal and is incorporated by reference into this ACO Program Addendum.
Participant and Preferred Provider shall cooperate with ACO’s care coordination protocols, which may include: permitting ACO to conduct telephonic and on-site utilization management and quality assurance activities; and/or requiring Participant or Preferred Provider to coordinate with ACO or other Participant or Preferred Provider hospital’s or facility’s care coordinators regarding the care of ACO Program Beneficiaries.
Participant and Preferred Provider shall participate in each ACO Program that qualifies for All Payer Model Scale Targets, for which a Program Addendum is provided within the time frames set forth in paragraph 3.1 (“Core ACO Programs”) and that is offered by a Payer for which Participant or Preferred Provider is an enrolled provider and in good standing, by signing an ACO Program Addendum for each such ACO Program.
In addition to OHCA sharing, Participant and Preferred Provider shall make the records available to and communicate as appropriate with each Participant, Preferred Provider, or ACO Other Entity, as needed, for the purpose of facilitating the delivery of appropriate Health Care Services to each ACO Program Beneficiary.
Participant and Preferred Provider shall implement such cost and quality control protocols or other interventions as may be adopted by ACO regarding the care of ACO Program Beneficiaries.