ACO Activities definition

ACO Activities means activities related to promoting accountability for the quality, cost, and overall care for a patient population of aligned Medicare fee-for-service Beneficiaries, including managing and coordinating care for Next Generation Beneficiaries; encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery; or carrying out any other obligation or duty of the ACO under this Agreement. Examples of these activities include, but are not limited to, providing direct patient care to Next Generation Beneficiaries in a manner that reduces costs and improves quality; promoting evidence-based medicine and patient engagement; reporting on quality and cost measures under this Agreement; coordinating care for Next Generation Beneficiaries, such as through the use of telehealth, remote patient monitoring, and other enabling technologies; establishing and improving clinical and administrative systems for the ACO; meeting the quality performance standards of this Agreement; evaluating health needs of Next Generation Beneficiaries; communicating clinical knowledge and evidence-based medicine to Next Generation Beneficiaries; and developing standards for Beneficiary access and communication, including Beneficiary access to medical records.

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ACO Activities means activities related to promoting accountability for the quality, cost, and overall care for a population of REACH Beneficiaries, including managing and coordinating care; encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery; or carrying out any other obligation or duty of the ACO under the Agreement. Examples of these activities include, but are not limited to, providing direct patient care in a manner that reduces costs and improves quality; promoting evidence-based medicine and patient engagement; reporting on quality and cost measures under the Agreement; coordinating care, such as through the use of telehealth, remote patient monitoring, and other enabling technologies; establishing and improving clinical and administrative systems for the ACO; meeting the quality performance standards of the Agreement; evaluating health needs; communicating clinical knowledge and evidence-based medicine; and developing standards for Beneficiary access and communication, including Beneficiary access to medical records.

ACO Activities means activities related to promoting accountability for the quality, cost, and overall care for a patient population of aligned Medicare fee-for-service Beneficiaries, including managing and coordinating care for Next Generation Beneficiaries; encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery; or carrying out any other obligation or duty of the ACO under this Agreement. Examples of these activities include, but are not limited to, providing direct patient care to Next Generation Beneficiaries in a manner that reduces costs and improves quality; promoting evidence-based medicine and patient engagement; reporting on quality and cost measures under this Agreement;

Examples of ACO Activities in a sentence

• The ACO shall ensure that it has written arrangements in place with any individuals and entities performing functions and services related to ACO Activities or Marketing Activities, that are necessary to ensure CMS or its designees can carry out evaluation activities.

• The ACO shall not, and shall require its Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities not to, use Marketing Materials or engage in Marketing Activities until such Marketing Materials and Marketing Activities are reviewed and approved by CMS, or deemed approved in accordance with Section 5.04.J.2.

• None of the provisions of the Agreement limit or restrict any other government authority that is permitted by law to audit, evaluate, investigate, or inspect the ACO, its Participant Providers, Preferred Providers or other individuals and entities performing functions or services related to ACO Activities or Marketing Activities.

• The ACO shall not, and shall require its Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities, not to, conduct Marketing Activities outside the scope of the Marketing Plan including, if applicable, any material changes to the ACO’s Marketing Plan described in a CMS-approved amendment.

• Except as otherwise specified in the Agreement, the ACO may use and may permit its Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities to conduct Marketing Activities through unsolicited direct contact with Beneficiaries using conventional mail and other print media or email, provided that Beneficiaries are given an opportunity to opt-out of subsequent unsolicited contacts.

• None of the provisions of the Agreement limit or restrict the OIG’s authority to audit, evaluate, investigate, or inspect the ACO, its Participant Providers, Preferred Providers or other individuals and entities performing functions or services related to ACO Activities or Marketing Activities.

• Unless the ACO participated in the Model during the Implementation Period, the ACO shall not conduct, and shall prohibit its Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities, from conducting Marketing Activities before the Start Date, or such other date specified by CMS.

• In conducting Marketing Activities, the ACO shall not, and shall require its Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities, not to, conduct communication or Marketing Activities targeted to Beneficiaries enrolled in Medicare Advantage or any other Medicare managed care plan.

• The ACO shall not and shall require Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities, not to, conduct Marketing Activities outside the ACO Service Area, as defined in Section 5.04.

• Consistent with Section 1802(a) of the Act, neither the ACO nor any Participant Provider, Preferred Provider, or other individuals or entities performing functions or services related to ACO Activities or Marketing Activities, shall commit any act or omission, nor adopt any policy, that inhibits Beneficiaries from exercising their freedom to obtain health services from providers and suppliers who are not Participant Providers or Preferred Providers.

More Definitions of ACO Activities

ACO Activities means refers to services provided by OneCare to a Payer’s beneficiaries or members under an ACO Program Agreement.

ACO Activities means activities engaged in by OneCare related to promoting accountability for the quality, cost, and overall care for a population of beneficiaries and members attributed to OneCare under the terms of any ACO Program agreement(s) between OneCare and any Payer(s), including managing and coordinating care; encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery; or carrying out any other obligation or duty of OneCare.