Cost-Containment Features; Health Management Program Sample Clauses

Cost-Containment Features; Health Management Program. The cost- containment and health management programs set forth in Section 13 of the VMEP, as amended by Section VIII.2.B.6 of the IBEW Mid-Atlantic 2012 MOU will apply to VCS employees. The VCS Medical Plan will be amended so that a “mirror image” of these cost-containment and health management program provisions will replace such provisions in the VCS Medical Plan.

Cost-Containment Features; Health Management Program. In addition to the cost-containment and health management programs set forth in Section 13 of the VMEP, the Company may provide associates and eligible dependents with an additional health management program, pursuant to which the Company may, from time to time, offer and implement health management and educational programs and initiatives that address effective health care utilization, health conditions, disease management and patient safety. The health management program may include the following programs that help manage health as set forth below. The Company will retain the discretion to add, eliminate and make changes to the programs offered from time to time in consultation with the TPA. The TPA will be Anthem. (Amend the following sections of the VMEP: Section 13 and delete Section 13.4.) a. Inpatient care advocacy (Voluntary Participation). If an associate or eligible dependent is hospitalized, the TPA works with the associate or eligible dependent’s physician to make sure that he or she is getting the care needed and that the physician’s treatment plan is being carried out effectively. b. Readmission management (Voluntary Participation). This program serves as a bridge between the hospital and home if an associate or eligible dependent is at high risk of being readmitted. c. Risk management (Voluntary Participation). If an associate or eligible dependent has certain chronic or complex conditions, this program addresses such health care needs by providing access to medical specialists, medication information and coordination of equipment and supplies. d. Disease management (Voluntary Participation). The TPA offers support for a wide variety of medical conditions. If an associate or eligible dependent has been diagnosed or is at high risk for the following, the TPA will provide guidance about the associate or eligible dependent’s condition at no additional cost: asthma, cancer, COPD, congestive heart failure, coronary artery disease, depression, diabetes, low back pain, musculoskeletal conditions and vascular at risk. e. Behavioral health support (Voluntary Participation). f. Maternity support (Voluntary Participation).