Common use of Stratification & Level of Service Clause in Contracts

Stratification & Level of Service. Based on the results of the initial screening as well as mining of historical claims data, the Contractor shall stratify its membership into various subpopulations to identify member level of service and ensure continuity of care. The outcome of the member assessment set forth above in Section 5.1 will determine the member’s needs in the stratification process resulting in the member’s assignment to one of the levels of care coordination service, set forth below in this Section 5.2. Prior to the Contract’s effective date, the Contractor will propose to FSSA a stratification methodology, which shall include a “rush” designation for members with immediate needs. The stratification plan must be approved by FSSA prior to member stratification. In addition, the care coordination classification system may be modified if the Contractor receives written approval from FSSA.

Stratification & Level of Service. Based on the results of the initial screening as well as mining of historical claims datadata and clinical data from health information exchanges, the Contractor shall stratify its membership into various subpopulations to identify member level of service and ensure continuity of care. The outcome of the member assessment set forth above in Section 5.1 will determine the member’s needs in the stratification process resulting in the member’s assignment to one of the levels of care coordination service, set forth below in this Section 5.2. Prior to the Contract’s effective date, the Contractor will propose to FSSA a stratification methodology, which shall include a “rush” designation for members with immediate needs. The stratification plan must be approved by FSSA prior to member stratification. In addition, the care coordination classification system may be modified if the Contractor receives written approval from FSSA.. EXHIBIT 1.A. SCOPE OF WORK

Stratification & Level of Service. Based on the results of the initial screening as well as mining of historical claims datadata and clinical data from health information exchanges, the Contractor shall stratify its membership into various subpopulations to identify member level of service and ensure continuity of care. The outcome of the member assessment set forth above in Section 5.1 will determine the member’s needs in the stratification process resulting in the member’s assignment to one of the levels of care coordination service, set forth below in this Section 5.2. Prior to the Contract’s effective date, the Contractor will propose to FSSA a stratification methodology, which shall include a “rush” designation for members with immediate needs. The stratification plan must be approved by FSSA prior to member stratification. In addition, the care coordination classification system may be modified if the Contractor receives written approval from FSSA.