Model of Care definition

Model of Care means the program designed by Health Plan and approved by CMS to meet the specialized needs of a Dual Eligible population that includes (i) an appropriate network of providers and specialists available through Health Plan’s D-SNP, and (ii) care management services, which include assessment, individualized plan of care and interdisciplinary team.
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Model of Care means a CMS required written care management plan for Dual Eligible Medicare Advantage Special Needs Plans (DESNP) with eleven model of care elements and 4 State specific elements
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Model of Care means the Model of Care and the Medical Termination of Pregnancy (has not exceeded nine (9) weeks of pregnancy) Care Pathway as published by the HSE and as may be amended from time to time in accordance with the requirements of Good Professional Practice.
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Examples of Model of Care in a sentence

  • Providers will have access to the Model of Care training via the Molina website.

  • Molina will issue a written request to Providers to participate in Model of Care training.

  • A designated Molina Quality Improvement Director and/or Medical Director will have responsibility for monitoring and evaluating the Model of Care.

  • Wellness program utilization rates.Molina will use the above data collection, analysis and reporting to develop a comprehensive evaluation of the effectiveness of the Molina Model of Care.

  • Screening is integrated into the clinical programs which comprise the Complete Care Model of Care including case management, discharge transitions, DM, and wellness.

  • Performance and Health Outcomes Measurement - Molina collects, analyzes reports and acts on data evaluating the Model of Care.

  • Our Model of Care reinforces and prioritizes recovery, stabilization, health maintenance, optimal safety and quality, and independence through partnering with our enrollee, their natural supports and providers.

  • If there is a trend of continued non-attestation, those providers found to be non-compliant with the Model of Care may be targeted for potential clinical interventions.

  • To evaluate the Model of Care, Molina may collect data from multiple sources including:a.

  • Building on the deep experience we have gained by providing integrated care to SMI enrollees in the specialty plan, our integrated, flexible, and comprehensive Model of Care continues to evolve to further expand and define services to meet the specialty needs of our highest-risk enrollees.

Related to Model of Care

  • Standard of Care has the meaning set forth in Section 14.1.

  • General-Purpose Software means Software that supports general-purpose office and software development activities and is identified as such in Appendix 4 of the Contract Agreement and such other Software as the parties may agree in writing to be General-Purpose Software. Such General- Purpose Software may include, but is not restricted to, word processing, spreadsheet, generic database management, and application development software.

  • Emergency Care means management for an illness or injury which results in symptoms which occur suddenly and unexpectedly, and requires immediate care by a medical practitioner to prevent death or serious long term impairment of the insured person’s health.

  • NAICS means North American Industry Classification System.