Case Management Strategies. The MCP must follow best-practice and/or evidence based clinical guidelines when devising a member’s care treatment plan and coordinating the case management needs. If an MCP uses a disease management methodology to identify and/or stratify members in need of case management services, the methods must be validated by scientific research and/or nationally accepted in the health care industry. The MCP must develop and implement mechanisms to educate and equip physicians and case managers with evidence-based clinical guidelines or best practice approaches to assist in providing a high level of quality of care to members.
Appears in 2 contracts
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc)
Case Management Strategies. The MCP must follow best-practice and/or evidence based clinical guidelines when devising a member’s care treatment plan and coordinating the case management needs. If an MCP uses a disease management methodology to identify and/or stratify members in need of case management services, the methods must be validated by scientific research and/or nationally accepted in the health care industry. The MCP must develop and implement mechanisms to educate and equip physicians providers and case managers with evidence-based clinical guidelines or best practice approaches to assist in providing a high level of quality of care to members.
Appears in 2 contracts
Samples: Provider Agreement (Molina Healthcare Inc), Provider Agreement (Wellcare Health Plans, Inc.)
Case Management Strategies. The MCP must MCPmust follow best-practice and/or evidence based clinical guidelines when devising developing a member’s care treatment plan and coordinating the case management needs. If an MCP uses a disease management methodology to identify and/or stratify members in need of case management services, the methods must be validated by scientific research and/or nationally accepted in the health care industry. The MCP must develop and implement mechanisms to educate and equip physicians providers and case managers with evidence-based clinical guidelines or best practice approaches to assist in providing a high level of quality of care to members.
Appears in 1 contract
Case Management Strategies. The MCP must follow best-practice and/or evidence based clinical guidelines when devising a member’s 's care treatment plan and coordinating the case management needs. If an MCP uses a disease management methodology to identify and/or stratify members in need of case management services, the methods must be validated by scientific research and/or nationally accepted in the health care industry. The MCP must develop and implement mechanisms to educate and equip physicians and case managers with evidence-based clinical guidelines or best practice approaches to assist in providing a high level of quality of care to members.
Appears in 1 contract