Common use of Administration of Blueprint Payment Processes Clause in Contracts

Administration of Blueprint Payment Processes. Enhanced payments under the Blueprint model include: • Per Person Per Month (PPPM) payments from all participating payers to practices that have been recognized as patient-centered medical homes (PCMHs) based on National Committee for Quality Assurance (NCQA) standards • CHT payments from all participating payers to support core CHT functions • CHT payments from Medicare to support the SASH program • CHT payments from DVHA/Medicaid to support the CHT-MAT staff Detailed information on providers, practices, and CHT administrative entities is required by commercial and public payers in order to implement these enhanced payments. The State provides the Blueprint Provider Directory (xxxxx://xxxxxxxxxxxxxxxxxxxxxxxx.xxxxxxx.xxx/) to project managers as the data collection tool for required information according to the following schedule: a. Total Unique Patients Reports: Each quarter, Grantee shall accurately enter and update practice-level patient counts, to determine CHT staffing ratios, prior to the fifteenth (15th) day of the last month of the calendar quarter (March, June, September, and December). b. Practice Rosters (Practice Summary Reports): Each month, on or about the fifteenth (15th) day of the month, the State shall notify and identify to the Grantee a cohort of those practices which are scheduled to undergo NCQA PCMH scoring approximately 4.5 months in the future. For those identified practices, Grantee shall enter and update all practice and provider information within a month, prior to the 15th day of the month following the notification date and identification of the list of practices to the Grantee from the State. c. CHT/MAT Staffing and Practice Demographics Reports: Each quarter, prior to the fifteenth (15th) day of the first month of each calendar quarter (January, April, July, and October), Grantee shall enter and update CHT/MAT staffing and practice demographics information. The Grantee shall report practice changes, such as provider transitions or attrition, to the State and all payers (with the exception of Medicare) as they occur via the Blueprint Provider Directory. The State reserves the right to require the Grantee to provide additional payment-related information or to require that the information described in this section be provided according to a different schedule or via an alternate set of data collection tools.

Administration of Blueprint Payment Processes. Enhanced payments under the Blueprint model include: •  Per Person Per Month (PPPM) payments from all participating payers to practices that have been recognized as patient-centered medical homes (PCMHs) based on National Committee for Quality Assurance (NCQA) standards •  CHT payments from all participating payers to support core CHT functions •  CHT payments from Medicare to support the SASH program •  CHT payments from DVHA/Medicaid to support the CHT-MAT staff Detailed information on providers, practices, and CHT administrative entities is required by commercial and public payers in order to implement these enhanced payments. The State provides the Blueprint Provider Directory (xxxxx://xxxxxxxxxxxxxxxxxxxxxxxx.xxxxxxx.xxx/) to project managers as the data collection tool for required information according to the following schedule: a. Total Unique Patients Reports: Each quarter, Grantee shall accurately enter and update practice-level patient counts, to determine CHT staffing ratios, prior to the fifteenth (15th) day of the last month of the calendar quarter (March, June, September, and December). b. Practice Rosters (Practice Summary Reports): Each month, on or about the fifteenth (15th) day of the month, the State shall notify and identify to the Grantee a cohort of those practices which are scheduled to undergo NCQA PCMH scoring approximately 4.5 months in the future. For those identified practices, Grantee shall enter and update all practice and provider information within a month, prior to the 15th day of the month following the notification date and identification of the list of practices to the Grantee from the State. c. CHT/MAT Staffing and Practice Demographics Reports: Each quarter, prior to the fifteenth (15th) day of the first month of each calendar quarter (January, April, July, and October), Grantee shall enter and update CHT/MAT staffing and practice demographics information. The Grantee shall report practice changes, such as provider transitions or attrition, to the State and all payers (with the exception of Medicare) as they occur via the Blueprint Provider Directory. The State reserves the right to require the Grantee to provide additional payment-related information or to require that the information described in this section be provided according to a different schedule or via an alternate set of data collection tools.

Administration of Blueprint Payment Processes. Enhanced payments under the Blueprint model include: • Per Person Per Month (PPPM) payments from all participating payers to practices that have been recognized as patient-centered medical homes (PCMHs) based on National Committee for Quality Assurance (NCQA) standards • CHT payments from all participating payers to support core CHT functions • CHT payments from Medicare to support the SASH program • CHT payments from DVHA/Medicaid to support the CHT-MAT staff Detailed information on providers, practices, and CHT administrative entities is required by commercial and public payers in order to implement these enhanced payments. The State provides the Blueprint Provider Directory (xxxxx://xxxxxxxxxxxxxxxxxxxxxxxx.xxxxxxx.xxx/) to project managers as the data collection tool for required information according to the following schedule: a. Total Unique Patients Reports: Each quarter, Grantee shall accurately enter and update practice-level patient counts, to determine CHT staffing ratios, prior to the fifteenth (15th) day of the last month of the calendar quarter (March, June, September, and December). b. Practice Rosters (Practice Summary Reports): Each month, on or about the fifteenth (15th) day of the month, the State shall notify and identify to the Grantee a cohort of those practices which are scheduled to undergo NCQA PCMH scoring approximately 4.5 months in the future. For those identified practices, Grantee shall enter and update all practice and provider information within a month, prior to the 15th day of the month following the notification date and identification of the list of practices to the Grantee from the State. c. CHT/MAT Staffing and Practice Demographics Reports: Each quarter, prior to the fifteenth (15th) day of the first month of each calendar quarter (January, April, July, and October), Grantee shall enter and update CHT/MAT staffing and practice demographics information. The Grantee shall report practice changes, such as provider transitions or attrition, to the State and all payers (with the exception of Medicare) as they occur via the Blueprint Provider Directory. The State reserves the right to require the Grantee to provide additional payment-related information or to require that the information described in this section be provided according to a different schedule or via an alternate set of data collection tools.