Coordinated Care Organizations definition

Coordinated Care Organizations or “CCO” means a corporation, governmental agency, public corporation, or other legal entity that is certified as meeting the criteria adopted by the Oregon Health Authority under ORS 414.625 to be accountable for care management and to provide integrated and coordinated health care for each of the organization’s members.
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Coordinated Care Organizations or “CCO” means an entity that has been certified by the Oregon Health Authority to provide coordinated and integrated health services.
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Examples of Coordinated Care Organizations in a sentence

  • Therefore, all existing rules need to be repealed to avoid redundant or conflicting rules in the oversight of the State’s Coordinated Care Organizations (CCOs).

  • They are designed to improve OHA’s financial oversight of Coordinated Care Organizations (CCOs).

  • Adopting rule for Qualified Directive Payments for Rural Type A/B and Public Academic Health Centers for Medicaid members enrolled in Coordinated Care Organizations.

  • The Oregon Health Authority (OHA) contracts with Coordinated Care Organizations (CCOs) to manage and deliver integrated services that include Physical Health, Behavioral Health, and Dental Services to over 90% of Oregon’s Medicaid population.

  • Sixteen Coordinated Care Organizations (CCOs) – which geographically cover the entire state – now deliver physical, oral and behavioral health services to approximately 90 percent of OHP members.

  • Sixteen Coordinated Care Organizations (CCOs) – which geographically cover the entire state – now deliver physical, oral, and behavioral health services to approximately 90 percent of OHP members.

  • Key features include: Coordinated Care Organizations (CCOs): The State established CCOs as the delivery system for Medicaid and CHIP services. Flexibility in use of federal funds: The State has ability to use Medicaid dollars for flexible services (e.g., non-traditional health care workers), to be used for health-related care that is authorized under managed care rules and regulations.

  • The Oregon Health Authority (OHA) contracts with Coordinated Care Organizations (CCOs) to manage and deliver integrated services that include Physical Health, Behavioral Health, and Dental Services to the majority of Oregon’s Medicaid population.

  • A change in assignment shall be honored if there is another DCO, MHO, PCO, or FCHP open for enrollment in the county in which the client resides; (10) Clients shall be enrolled with PHPs according to the following criteria: (a) Areas with sufficient physical health service capacity through a combination of Coordinated Care Organizations (CCOs), Fully Capitated Health Plans (FCHP), and Physician Care Organizations (PCO) shall be called mandatory service areas.

  • Qualified directed payments from the Rural Type A/B hospital services quality and access pool are tied to actual hospital services provided: the number of inpatient discharges and outpatient visits reported by Rural Type A/B hospitals to Coordinated Care Organizations (CCOs).

Related to Coordinated Care Organizations

  • Coordinated care organization means an organization meeting criteria adopted by the

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • Managed Care Organization (MCO) means a contracted health delivery system providing capitated or prepaid health services, also known as a Prepaid Health Plan (PHP). An MCO is responsible for providing, arranging, and making reimbursement arrangements for covered services as governed by state and federal law. An MCO may be a Chemical Dependency Organization (CDO), Dental Care Organization (DCO), Mental Health Organization (MHO), or Physician Care Organization (PCO).

  • Health care organization ’ means any person or en-

  • Provider Organization means a group practice, facility, or organization that is:

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Procurement organization means an eye bank, organ procurement organization, or tissue bank.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Independent review organization means an entity that is accredited to conduct independent external reviews of adverse benefit determinations.

  • Utilization review organization means an entity that conducts utilization review, other than a health carrier performing a review for its own health benefit plans.

  • Coordinated licensure information system means an integrated process for collecting, storing, and sharing information on nurse licensure and enforcement activities related to nurse licensure laws that is administered by a nonprofit organization composed of and controlled by licensing boards.

  • Medicaid program means the Kansas program of medical

  • Organ procurement organization means a person designated by the Secretary of the United States Department of Health and Human Services as an organ procurement organization.

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • Child care program means a person or business that offers child care.

  • Child care services means the range of activities and programs provided by a certificate holder to an enrolled child, including personal care, supervision, education, guidance, and transportation.

  • Child welfare services means social services including

  • Review organization means a disability insurer regulated

  • Accountable care organization or “ACO” means an organization of health care providers that has a formal legal structure, is identified by a federal Taxpayer Identification Number, and agrees to be accountable for the quality, cost, and overall care of the patients assigned to it.

  • Health maintenance organization (HMO) means a public or private health care organization that is a federally qualified HMO under Section 1310 of the U.S. Public Health Services Act. HMOs provide health care services on a capitated, contractual basis.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Medical evaluation means the process of assessing an individual's health status that includes a medical history and a physical examination of an individual conducted by a licensed medical practitioner operating within the scope of his license.

  • Quality improvement organization or “QIO” shall mean the organization that performs medical peer review of Medicaid claims, including review of validity of hospital diagnosis and procedure coding information; completeness, adequacy and quality of care; appropriateness of admission, discharge and transfer; and appropriateness of prospective payment outlier cases. These activities undertaken by the QIO may be included in a contractual relationship with the Iowa Medicaid enterprise.

  • Credit union service organization means an organization, corporation, or association whose membership or ownership is primarily confined or restricted to credit unions or organizations of credit unions and whose purpose is primarily designed to provide services to credit unions, organizations of credit unions, or credit union members.

  • Primary care physician means a physician qualified to be an attending physician according to ORS 656.005(12)(b)(A) and who is a general practitioner, family practitioner, or internal medicine practitioner.

  • Employee organization means any organization, union, or