Common use of Participating Safety Net Hospital Clause in Contracts

Participating Safety Net Hospital. a Safety Net Hospital that affiliates with the Contractor for the purposes of this Contract as described in Section 2.2.D. Patient Experience Survey – a survey of Enrollees’ experiences of care, performed to evaluate the Contractor’s performance, as described in Appendix B. requested by the Enrollee and agreed to by the Enrollee’s PCP, the PCP Designee may also be a specialist, such as an Enrollee’s cardiologist or neurologist, who meets the requirements of a PCP Designee. If agreed to by the Enrollee and by the Enrollee’s PCP, the PCP Designee may also be an ACO clinical staff person who meets the requirements of a PCP Designee. Progress Reports – information provided by the Contractor on the Contractor’s activities under this Contract, as described in Section 5.1.C. Quality Measures – Measures used to evaluate the quality of the Contractor’s Enrollee care as described in Appendix B. Quality Sample – a subset of Enrollees defined by EOHHS used for measurement of Clinical Quality Measures as set forth in Appendix B. Quality Score – a score calculated by EOHHS based on the Contractor’s performance on Quality Measures, as described in Appendix B. Rating Category (RC) – An identifier used by EOHHS to identify a specific grouping of Enrollees for which a discrete TCOC applies pursuant to the Contract. Rating Categories include RC I Adult, RC I Child, XX XX Adult, XX XX Child, RC IX, and XX X. XX XX Adult, as used in Section 4, includes Enrollees who are disabled, age 21 to 64, and in MassHealth Standard or CommonHealth as described in 130 CMR 505. Referral Circle – a subset of Affiliated Providers for whom Participating PCP referral requirements are modified as set forth in 130 CMR 450.119 and as described in Section 3.2. Region – A geographic area used for the purpose of the development of TCOC. See Section 4.

Appears in 4 contracts

Samples: Primary Care Accountable Care Organization Contract, Primary Care Accountable Care Organization Contract, Primary Care Accountable Care Organization Contract

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