Population Health Management. We offer a variety of services to you through our Population Health Management program which includes Case Management. Case management is available to all plan members who need assistance with coordinating health care services and/or accessing resources. Registered nurses, pharmacists and social workers, referred to as Care Managers, assist members with needs spanning behavioral services and the medical community. If you are facing a serious illness or medical condition, then Case Management may be right for you. Case Management Services General Case Management and disease specific case management programs are available. The goals of these services are:
Population Health Management. An approach to maintain and improve physical and psychosocial well-being and address health disparities through cost-effective, person-centered health solutions that address members' health needs in multiple settings at all points along the continuum of care. Post-Stabilization Care Services – As defined in OAC rule 5160-26-01, covered services related to an emergency medical condition that a treating provider views as medically necessary after an emergency medical condition has been stabilized in order to maintain the stabilized condition, or under the circumstances described in 42 CFR 422.113 to improve or resolve the member's condition.
Population Health Management. All Participating practices must engage in the Clinical Practice Improvement Activities to support Population Health Management as outlined below. Participants which selected a Practice Transformation Objective other than Population Health Management in 2017 may continue to pursue that objective (e.g. telehealth adoption) but are required to realign their objective as an activity which corresponds with improving performance on one or more of their population health objectives.
Population Health Management. 6.5.1 Contractor’s Care Model shall include strategies for supporting Members at various levels of risk; for example, those Members identified as low risk, medium or rising risk, high risk, and very high risk of experiencing complex health conditions. Within 90 days of the beginning of each Performance Year, Contractor shall use best practices and predictive modeling tools to conduct comprehensive screening and risk stratification to predict all Attributed Members’ risk (if possible, including tools that address needs of specific sub-populations and risk related to social determinants of health). Contractor shall provide information about screening and risk stratification tools and results to DVHA upon request.
Population Health Management. 2.5.2.1. The ICDS Plan is required to develop a model of care that broadly defines the way services will be delivered by the ICDS Plan, and includes requirements specified in Sections 2.5.2 and 2.5.3 of this Contract.
Population Health Management. A. Data Aggregation and Analysis
Population Health Management. 2.5.2.1. The ICDS Plan shall abide by the care delivery model described within this Contract and is not required to submit a model of care to CMS or ODM unless otherwise requested.
Population Health Management. An approach to maintain and improve physical and psychosocial well- being and address health disparities through cost-effective, person-centered health solutions that address members' health needs in multiple settings at all points along the continuum of care. Post-Stabilization Care Services – As defined in OAC rule 5160-26-01, covered services related to an emergency medical condition that a treating provider views as medically necessary after an emergency medical condition has been stabilized in order to maintain the stabilized condition, or under the circumstances described in 42 CFR 422.113 to improve or resolve the member's condition. Prepaid Inpatient Health Plan (PIHP) – As defined in 42 CFR 438.2, a PIHP is an entity that 1) provides services to enrollees under contract with the State, and on the basis of capitation payments, or other payment arrangements that do not use State plan payment rates; 2) provides, arranges for, or otherwise has responsibility for the provision of any inpatient hospital or institutional services for its enrollees; and
Population Health Management. A coordinated, data-informed approach to implementing strategies and interventions designed to address the drivers of poor health outcomes in specific populations and communities with the goal of improving physical and psychosocial well-being.
Population Health Management. Identification and Triage
