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  5. Health Choices Agreement Exhibit B(5): Community Based Care Management Program

Health Choices Agreement Exhibit B(5): Community Based Care Management Program

Year:
2020
State:
PA
Website Link:
Publicly Available:
Yes
Billing and Reimbursement:
Certification:
Evidence Generation:
Policy:
MCO contract language and reimbursement models
Sustainable Financing:​
How to engage and work with Medicaid, Including community-based CHWs, Education to HC orgs on payment options bundled etc., MCO or bundled payment reimbursement models
Workforce Development:

Summary

The Community Based Care Management (CBCM) Program requirements described in this Exhibit B(5) are for care rendered during a CY and defined in the PH-MCO specific CBCM Program approved by the Department per Section I below. Proposals submitted for the CBCM program must increase the use of community-based staff, including certified Community Health Workers where appropriate, to encourage the use of preventive services, identify and resolve barriers to care, and mitigate social determinates of health.