Improving Care, Promoting Better Health and Lowering Costs. 1.01 Coordination and Cooperation. Contractor and the Exchange agree that the Quality, Network Management and Delivery System Standards serve as a starting point for what must be ongoing, refined and expanded efforts to promote improvements in care for Enrollees and across Contractor’s California members. Improving and building on these efforts to improve oral health care and reduce administrative burdens will require active partnership between both the Exchange and the Contractor, but also with Providers, consumers and other important stakeholders.
(a) The Exchange shall facilitate ongoing discussions with the Contractor and other stakeholders through the Exchange’s Plan Management and Delivery System Reform Advisory Group and through other forums as may be appropriate to work with Contractors to assess the elements of this Section and their impact, and ways to improve upon them on:
(i) Enrollees and other consumers;
(ii) Providers in terms of burden, changes in payment and rewarding the triple aim of improving care, promoting better health and lowering costs; and
(iii) Contractors in terms of the burden of reporting, participating in quality or delivery system efforts.
(b) The Contractor agrees to participate in Exchange advisory and planning processes, including but not limited to participating in the Plan Management and Delivery System Reform Advisory Group.
Improving Care, Promoting Better Health and Lowering Costs. 1.01 Coordination and Cooperation. Contractor and the Exchange agree that the Quality, Network Management and Delivery System Standards serve as a starting point for what must be ongoing, refined, and expanded efforts to promote improvements in care for Enrollees and across Contractor’s California members. Improving and building on these efforts to improve oral health care and reduce administrative burdens will require active partnership between both the Exchange and the Contractor, but also with Providers, consumers, and other important stakeholders.
(a) The Exchange shall facilitate ongoing discussions with the Contractor and other stakeholders through the Exchange’s Plan Management and Delivery System Reform Advisory Group, Dental Technical Workgroup, and through other forums as may be appropriate to work with Contractors to assess the elements of this section and their impact, and ways to improve upon them, on:
(i) Enrollees and other consumers;
(ii) Providers in terms of burden, changes in payment and rewarding the Triple Aim of improving care, promoting better health, and lowering costs; and
(iii) Contractors in terms of the burden of reporting, participating in quality or delivery system efforts.
(b) The Contractor agrees to participate in Exchange advisory and planning processes, including but not limited to participating in the Plan Management and Delivery System Reform Advisory Group and Dental Technical Workgroup.
Improving Care, Promoting Better Health and Lowering Costs. Coordination and Cooperation. Contractor and the Exchange agree that the Quality, Network Management and Delivery System Standards serve as a starting point for what must be ongoing, refined and expanded efforts to promote improvements in care for Enrollees and across Contractor’s California members. Improving and building on these efforts to improve oral health care and reduce administrative burdens will require active partnership between both the Exchange and the Contractor, but also with Providers, consumers and other important stakeholders.
Improving Care, Promoting Better Health and Lowering Costs
