Care Coordination Program. 4.4.2.1 The CONTRACTOR shall design and implement a Care Coordination program that meets the requirements in Section 4.4 of this Agreement. 4.4.2.2 The CONTRACTOR’s Care Coordination program shall be consistent and comply with the requirements in the Managed Care Policy Manual and MCO Systems Manual. 4.4.2.3 The CONTRACTOR shall submit a written Care Coordination program description for HCA’s prior written approval. After the initial submission, the CONTRACTOR shall annually submit a data driven, written evaluation of its Care Coordination program, addressing Member outcomes, identifying areas for improvement, actions taken in response, and any proposed changes to the Care Coordination program for HCA review and prior written approval. 4.4.2.4 The CONTRACTOR’s Care Coordination program description must address each of the following program components, and meet the Care Coordination requirements set forth in this Section 4.4 of this Agreement: 4.4.2.4.1 Care Coordination staffing and training; 4.4.2.4.2 Assessments; 4.4.2.4.3 Care Coordination Level Assignment; 4.4.2.4.4 Comprehensive Care Plan; 4.4.2.4.5 Care Coordination activities; 4.4.2.4.6 Disease Management approach; 4.4.2.4.7 Care Coordination for special and high needs populations; 4.4.2.4.8 Delegated Care Coordination Models (Full Delegation Model or Shared Functions Model, when offered), including the CONTRACTOR’s strategies to promote, support, and expand the availability and use of the Full Delegation Model and the Shared Functions Model (when offered) of Care Coordination; 4.4.2.4.9 Transitions of care; 4.4.2.4.10 Care Coordination systems and analytics; and 4.4.2.4.11 Care Coordination monitoring and reporting.
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Samples: Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement
Care Coordination Program. 4.4.2.1 The CONTRACTOR shall design and implement a Care Coordination program that meets the requirements in Section 4.4 of this Agreement.
4.4.2.2 The CONTRACTOR’s Care Coordination program shall be consistent and comply with the requirements in the Managed Care Policy Manual and MCO Systems Manual.
4.4.2.3 The CONTRACTOR shall submit a written Care Coordination program description for HCAHSD’s prior written approval. After the initial submission, the CONTRACTOR shall annually submit a data driven, written evaluation of its Care Coordination program, addressing Member outcomes, identifying areas for improvement, actions taken in response, and any proposed changes to the Care Coordination program for HCA HSD review and prior written approval.
4.4.2.4 The CONTRACTOR’s Care Coordination program description must address each of the following program components, and meet the Care Coordination requirements set forth in this Section 4.4 of this Agreement:
4.4.2.4.1 Care Coordination staffing and training;
4.4.2.4.2 Assessments;
4.4.2.4.3 Care Coordination Level Assignmentassignment;
4.4.2.4.4 Comprehensive Care Plan;
4.4.2.4.5 Care Coordination activities;
4.4.2.4.6 Disease Management approach;
4.4.2.4.7 Care Coordination for special and high needs populations;
4.4.2.4.8 Delegated Care Coordination Models (Full Delegation Model or Shared Functions Model, when offered), including the CONTRACTOR’s strategies to promote, support, and expand the availability and use of the Full Delegation Model and the Shared Functions Model (when offered) Models of Care Coordination;
4.4.2.4.9 Transitions of care;
4.4.2.4.10 Care Coordination systems and analytics; and;
4.4.2.4.11 Care Coordination monitoring and reporting.
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