Common use of Disease Management Clause in Contracts

Disease Management. The Contractor must have and comply with written protocols to manage the care for Enrollees identified with congestive heart failure, chronic obstructive pulmonary disease, diabetes, and depression and a reporting system that produces clinical indicator data as required in Subsection 2.14(A)(2)&(4). The protocols must include the following: a. Written practice guidelines, in accordance with accepted clinical practice, including diagnostic, pharmacological, and functional standards; b. Measurement and distribution of reports relating to Contractor and PCP/PCT compliance with practice guidelines; c. Educational programming for Enrollees and caregivers that emphasizes self-care and maximum independence; d. Formal educational processes for clinical Providers in the best practices of managing the disease; and e. Evaluation of effectiveness of each program by measuring outcomes of care.

Disease Management. The Contractor must have and comply with written protocols to manage the care for Enrollees identified with congestive heart failure, chronic obstructive pulmonary disease, diabetes, and depression and a reporting system that produces clinical indicator data as required in Subsection 2.14(A)(2)&(4). The protocols must include the following: a. Written practice guidelines, in accordance with accepted clinical practice, including diagnostic, pharmacological, and functional standards; b. Measurement and distribution of reports relating to Contractor and PCP/PCT compliance with practice guidelines; c. Educational programming for Enrollees and caregivers that emphasizes self-care self‑care and maximum independence; d. Formal educational processes for clinical Providers in the best practices of managing the disease; and e. Evaluation of effectiveness of each program by measuring outcomes of care.