Delivery Systems and Benefits Sample Clauses

Delivery Systems and Benefits. IV.C.3.a. For beneficiaries who elect to receive health home services, the Health Home Care Coordinator will perform a comprehensive in-person health screening and work with the beneficiary to complete a Health Action Plan within 90 days of the date when the Lead Entity was notified of the beneficiary’s health home eligibility.
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Delivery Systems and Benefits. The Demonstration will not fundamentally change benefits packages, choice of providers and plans for Beneficiaries, or the ways in which the MSHO Plans contract with either the State and CMS. However, MSHO is an important vehicle for wider adoption of delivery system reforms throughout Minnesota. Building on provider contracting arrangements under MSHO and its current Medicaid Health Care Home benefit, the State will promote relationships between MSHO Plans and providers called Integrated Care System Partnerships (ICSPs). The goals of these ICSPs are to improve coordination between Medicare and Medicaid services and, ultimately, to help Beneficiaries remain in their homes or choice of community settings and improve health outcomes in all settings. The State has developed a range of ICSP arrangements based on provider interest and capacity, as well as geographic and demographic factors. The State’s MSHO contracts outline the following models:‌  Model 1. Health Care Home-based Virtual Integrated Care System Partnerships (Virtual ICSPs). Minnesota created Health Care Homes (HCHs) to provide payments to primary care providers that would incent better coordination of the entire spectrum of care provided to an individual. Building on the current all-payer HCH requirements in Minnesota, under the Demonstration the State and MSHO Plans will identify options for increasing coordination among MSHO Plans and the plan care coordinators, contracted clinics, and practitioners certified as health care homes, as well as with other contracted providers.‌  Model 2. HCH or HCH alternative based primary, acute, and/or long term care ICSPs. This model builds on the State’s HCH approach to further integrate primary and long term care coordination and delivery. New contract requirements require each MSHO plan to submit proposals for ICSPs to the State for review and to implement new arrangements no later than January 2014. About 20 ICSP proposals are expected. The ICSPs will also allow plans to‌ strengthen and revise current primary care partnerships already existing within the MSHO Plans. The new contracting requirements tie provider performance to a range of financial metrics including pay for performance goals, performance pools, and total cost of care systems with risk/gain parameters. These arrangements facilitate the integration of HCH coordination provided by primary care providers with other all care coordination provided under the Medicaid acute and long term care and...
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Delivery Systems and Benefits. For beneficiaries who elect to receive health home services, the Health Home Care Coordinator will perform a comprehensive in-person health screening and work with the beneficiary to complete a Health Action Plan within 90 days of the date when the Lead Entity was notified of the beneficiary’s health home eligibility. Beneficiary Protections, Participation and Customer Service Beneficiary Participation on Governing and Advisory Boards: As part of the Demonstration, CMS and the State shall require Health Home Networks to establish mechanisms to ensure meaningful beneficiary input processes and the involvement of beneficiaries in planning and process improvements. This will be addressed in the State’s qualification process for Health Home Networks. In addition, the State will provide avenues for ongoing beneficiary or beneficiary advocates to provide input into the Demonstration model, including participation in the Service Experience Team (SET). The SET works in partnership with the State to promote choice, quality of life, health, independence, safety, and active engagement to program improvement and development. The SET consists of up to 12 clients representing a diverse cross-section of geography, gender and programs being utilized, three to five Advocacy Representatives, a Tribal Representative, and State staff. Feedback collected by the State will be shared with Health Home Networks and will be part of the State’s process improvement efforts. Administration and Reporting Readiness Review: See Section III for discussion of Readiness Review. Monitoring: Intentionally Left Blank Quality Management: See Section IV.J for additional detail. Financing and Payment: See Sections IV.I and IV.J for additional detail. Evaluation: Intentionally Left Blank DEFINITIONS (APPENDIX 1 of the MOU): The following terms are added: Region 1: The 37 original counties in which the Demonstration began operating in 2013, specifically: Xxxxx, Asotin, Xxxxxx, Chelan, Clallam, Xxxxx, Columbia, Cowlitz, Douglas, Ferry, Franklin, Garfield, Grant, Grays Harbor, Island, Jefferson, Kitsap, Kittitas, Klickitat, Xxxxx, Xxxxxxx, Xxxxx, Okanogan, Pacific, Pend Oreille, Xxxxxx, San Xxxx, Skagit, Skamania, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Xxxxxxx, and Yakima counties Region 2: King and Snohomish counties CMS STANDARDS AND CONDITIONS AND SUPPORTING STATE DOCUMENTATION (APPENDIX 2 of the MOU) Intentionally Left Blank DETAILS OF THE STATE DEMONSTRATION AREA (APPENDIX ...
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Delivery Systems and Benefits 
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Related to Delivery Systems and Benefits

  • Effective Date of Wages and Benefits All non-compensatory provisions, wages and benefits shall be effective from Date of Ratification unless otherwise specified in this Collective Agreement.

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  • Pay and Benefits A. The Agency shall continue to pay salary and benefits which includes pension contribution, insurance and paid leave time consistent with what they earned before their appointment. Employees appointed as a Contract Specialist shall not be eligible for reimbursement for uniforms, boots or other ancillary items while serving as a Contract Specialist the specifics which will be noted in the employee’s Contract Specialist agreement.

  • Risks and Benefits of Therapy Psychotherapy is a process in which Therapist and Patient discuss a myriad of issues, events, experiences and memories for the purpose of creating positive change so Patient can experience his/her life more fully. It provides an opportunity to better, and more deeply understand oneself, as well as, any problems or difficulties Patient may be experiencing. Psychotherapy is a joint effort between Patient and Therapist. Progress and success may vary depending upon the particular problems or issues being addressed, as well as many other factors. Participating in therapy may result in a number of benefits to Patient, including, but not limited to, reduced stress and anxiety, a decrease in negative thoughts and self-sabotaging behaviors, improved interpersonal relationships, increased comfort in social, work, and family settings, increased capacity for intimacy, and increased self-confidence. Such benefits may also require substantial effort on the part of Patient, including an active participation in the therapeutic process, honesty, and a willingness to change feelings, thoughts and behaviors. There is no guarantee that therapy will yield any or all of the benefits listed above. Participating in therapy may also involve some discomfort, including remembering and discussing unpleasant events, feelings and experiences. The process may evoke strong feelings of sadness, anger, fear, etc. There may be times in which Therapist will challenge Patient’s perceptions and assumptions, and offer different perspectives. The issues presented by Patient may result in unintended outcomes, including changes in personal relationships. Patient should be aware that any decision on the status of his/her personal relationships is the responsibility of Patient. During the therapeutic process, many patients find that they feel worse before they feel better. This is generally a normal course of events. Personal growth and change may be easy and swift at times, but may also be slow and frustrating. Patient should address any concerns he/she has regarding his/her progress in therapy with Therapist. Professional Consultation Professional consultation is an important component of a healthy psychotherapy practice. As such, Therapist regularly participates in clinical, ethical, and legal consultation with appropriate professionals. During such consultations, Therapist will not reveal any personally identifying information regarding Patient.

  • PRESENT CONDITIONS AND BENEFITS All rights, benefits and working conditions which employees now enjoy, receive or possess as employees of the Employer shall continue to be enjoyed and possessed insofar as they are consistent with this Agreement but may be modified by mutual agreement between the Employer and the Union.

  • Compensation and Benefits As compensation for all services performed by the Executive under and during the term hereof and subject to performance of the Executive’s duties and of the obligations of the Executive to the Company and its Affiliates, pursuant to this Agreement or otherwise:

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