Difference between revisions of "Value-Based Care Contracts"

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Latest revision as of 13:22, 1 March 2019

Contract Terms

  • Patient Population Demographics
  • Fee Schedule vs Medicare – CPT/HCPCS Variants (i.e., AVW included?)
  • Patient Population Benefits – co-payments, formularies, networks, etc.
  • Patient Attribution
  • Patient Notification & Authorizations
  • Patient Documentation
  • Quality Measures/Star Rating, Care Gaps
  • Data Sharing – detailed claims, member lists, etc.
  • Benchmarks/Budgets
  • Shared Savings/Loss Calculations
  • Performance Based Incentives
  • Performance Based Payment Calculations

Joint Operating Agreement - Joint Venture

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