Common use of Utilization Rate Clause in Contracts

Utilization Rate. Measure: The number of emergency department visits in the reporting year where the principal diagnosis was CAD, per thousand member months, for members who had a diagnosis of CAD in the year prior to the reporting year. Target: TBD Minimum Performance Standard: The level of improvement must result in at least a TBD% decrease in the difference between the target and the previous report period’s results.

Appears in 4 contracts

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc)

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Utilization Rate. Measure: The number of emergency department visits in the reporting year where the principal diagnosis was CAD, per thousand member months, for members who had a diagnosis of CAD in the year prior to the reporting year. Target: TBD Minimum Performance Standard: The level of improvement must result in at least a TBD% decrease in the difference between the target and the previous report period’s 's results.

Appears in 1 contract

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan Abd Eligible Population (Wellcare Health Plans, Inc.)

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Utilization Rate. Measure: The number of emergency department visits in visitsin the reporting year where the principal diagnosis was CAD, per thousand member months, for members who had a diagnosis of diagnosisof CAD in the year prior to the reporting year. Target: TBD Minimum Performance Standard: The level of improvement must result in at least a TBD% decrease in the difference between the target and the previous report period’s results.

Appears in 1 contract

Samples: Provider Agreement (Wellcare Health Plans, Inc.)

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