Managed care arrangement definition

Managed care arrangement or "MCA” means a system that may use capitated financing to deliver high quality services and promote and optimize health outcomes through a medical home. Such an arrangement also includes services and supports that optimize the health and independence of beneficiaries who are determined to need or be at risk for Medicaid funded LTSS. An MCA includes any arrangement under which an MCO or contracted entity is granted some or all of the responsibility for providing and/or paying for long­term care services and supports through a contractual agreement with the Medicaid program.
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Managed care arrangement means an agreement offered by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services through the covered person’s use of health care providers managed by, owned by, under contract with, or employed by the insurer because the insurer creates incentives, including financial incentives, for the covered person’s use of those providers. A managed care arrangement includes, but is not limited to, and HMO or PPO arrangement.
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Managed care arrangement. ’ means, with respect to
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Related to Managed care arrangement

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Managed care means a system that provides the coordinated delivery of services and supports that are necessary and appropriate, delivered in the least restrictive settings and in the least intrusive manner. Managed care seeks to balance three factors: achieving high-quality outcomes for participants, coordinating access, and containing costs.

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • Joint service arrangements means agreements between or

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • Health care facility or "facility" means hospices licensed

  • Adult foster care facility means an adult foster care facility licensed under the adult foster care facility licensing act, 1979 PA 218, MCL 400.701 to 400.737.

  • Continuing care contract means, as stated in RCW 70.38.025, a contract providing a person, for the duration of that person's life or for a term in excess of one year, shelter along with nursing, medical, health-related, or personal care services, which is conditioned upon the transfer of property, the payment of an entrance fee to the provider of such ser- vices, or the payment of periodic charges for the care and ser- vices involved. A continuing care contract is not excluded from this definition because the contract is mutually termina- ble or because shelter and services are not provided at the same location.

  • HMO a health maintenance organization doing business as such (or required to qualify or to be licensed as such) under HMO Regulations.

  • Child care facility or “facility” means a child care center, a preschool, or a registered child development home.

  • Database Management System (“DBMS”) is a computer process used to store, sort, manipulate and update the data required to provide Selective Routing and ALI.

  • Long-term care facility means a nursing home, retirement care, mental care, or other facility or institution that provides extended health care to resident patients.