Outcome. a desirable situation, condition, or circumstance in a member’s life that can be a result of the support provided by effective care management. Outcomes defined include: a) Clinical outcome is an identified need, condition or circumstance that relates to a member’s individual physical, mental, or emotional health, safety, or well-being. Clinical outcomes are objectively measurable by someone other than the member, and their presence or absence can be determined without knowing the member’s preferences regarding the condition or circumstance. Clinical outcomes, along with functional outcomes, are referred to as “long term care” outcomes on the Member Care Plan (MCP). b) Functional outcome is an identified need, condition or circumstance that results in limitations on the member’s ability to perform certain functions, tasks, or activities and require additional support to help the member maintain or achieve their highest level of independence. This includes, but is not limited to, assistance with Activities of Daily Living and Instrumental Activities of Daily Living. The presence, absence, or degree of functional outcomes can be objectively measurable by someone other than the member, and their presence or absence can be determined without knowing the member’s preferences regarding the functional ability. Functional outcomes, along with clinical outcomes, are referred to as “long term care” outcomes in the member’s MCP.
Appears in 10 contracts
Samples: Pace Contract, Family Care Agreement, Pace Contract
