Model of Care. (a) The MA Health Plan agrees to provide EOHHS on an annual basis its approved Model of Care (“MOC”) to ensure alignment with EOHHS expectations and care coordination of Medicaid benefits.
Model of Care. 2.5.1.8.1. The ICO, in partnership with network providers, must implement an evidence-based model of care consistent with and the requirements set forth in this section and Section 2.6
Model of Care. All Participating Plans (in partnership with contracted providers) will be required to implement an evidence-based model of care (MOC) having explicit components consistent with the SNP Model of Care. California’s comprehensive care coordination requirements summarized in section IV will also apply and be outlined in the three-way contract. CMS’ MOC approval process is based on scoring each of the eleven clinical and non-clinical elements of the MOC. California included supplemental information in each of the eleven elements specific to integrated benefits and services under the demonstration. The supplemental information included care coordination, long-term services and supports, and behavioral health. CMS and California do not believe the supplemental information conflicts with the SNP Model of Care elements. The scoring methodology is divided into three parts: (1) a standard; (2) elements; and (3) factors. These components of the MOC approval methodology are defined below:
Model of Care. Under the Medicare Advantage program, a Special Needs Plan is required to have a model of care. All SNPs’ models of care must be approved by NCQA based on CMS standards and the requirements in 42 CFR §§ 422.4(a)(iv), 422.101(f), and 422.152(g). Prior to the next scheduled MOC submission for each MSHO SNP, CMS will give the State an opportunity to tailor the MOC elements, to reflect the MSHO requirements and processes, subject to CMS approval.
Model of Care. (i) A project has been set up to develop a new model of patient care which may include the classifications of Enrolled Nurses and/or Enrolled Nurses - Special Grade and any other classifications which may assist nurses in performing their professional duties.
Model of Care. 2.5.8.1 The Demonstration Plan, in partnership with network Providers, must implement an evidence-based model of care consistent with the requirements set forth in this section and Section 2.6.
Model of Care. 4.4.1 MA Health Plan will include in its Model of Care (MOC):
Model of Care. ANMF seek a commitment that a new model of care (which may include a hybrid Nursing Hours Per Patient Day/Ratio tool) will be implemented as a matter of urgency. The model should provide indirect care hours for the following: Associate Nurse Unit Managers, Nurse Unit Managers, Clinical Nurse Educators, Clinical Nurse Consultants, Clinical Nurse Specialists and Clinical Coordinators. Any recommended model which is adopted should apply to all areas within the THS. Further ANMF seek a model to compliment the agreed Birthrate Plus methodology which calculates staffing requirements for infant/neonates across maternity units. A date for introduction of agreed workload provisions to be included in the agreement.
Model of Care. All CICOs (in partnership with contracted providers) will be required to implement an evidence-based model of care (MOC) having explicit components consistent with the Special Needs Plan Model of Care. CMS’ CICO MOC approval process will be based on scoring each of the thirteen clinical and non-clinical elements of the MOC (both CMS and State elements are included). The scoring methodology is divided into three parts: (1) a standard; (2) elements; and (3) factors. These components of the MOC approval methodology are defined below:
Model of Care. All ICDS health plans (in partnership with contracted providers) will be required to implement an evidence-based model of care (MOC) having explicit components consistent with the Special Needs Plan Model of Care. Ohio’s comprehensive care management program requirements summarized in Section IV will also apply and be outlined in the three-way contract and the ICDS Plan provider agreement. CMS’ Demonstration plan MOC approval process will be based on scoring each of the eleven clinical and non-clinical elements of the MOC. The scoring methodology is divided into three parts: (1) a standard; (2) elements; and (3) factors. These components of the MOC approval methodology are defined below:
