Value-Based Programs under Negotiated Arrangements Sample Clauses
The "Value-Based Programs under Negotiated Arrangements" clause defines how parties may participate in healthcare payment or service models that reward value and outcomes rather than volume. This clause typically outlines the terms under which providers and payers can enter into agreements that tie compensation to performance metrics, such as quality of care, patient outcomes, or cost savings. For example, it may allow for shared savings arrangements, bundled payments, or pay-for-performance initiatives. Its core function is to enable flexible, innovative payment structures that incentivize better healthcare results while managing costs, addressing the need for adaptability in a changing healthcare landscape.
Value-Based Programs under Negotiated Arrangements. If Claim Administrator has entered into a Negotiated Arrangement with a Host Blue to provide Value-Based Programs to Employer’s Covered Persons, Claim Administrator will follow the same procedures for Value-Based Programs administration and Care Coordinator Fees as noted in BlueCard Program section.
Value-Based Programs under Negotiated Arrangements. If BCBSNE has entered into a Negotiated Arrangement/Negotiated National Account Arrangement with a Host Blue to provide Value-Based Programs to THE GROUP’s Covered Persons, BCBSNE will follow the same procedures for Value-Based Programs administration and Care Coordination Fees as noted in the BlueCard Program section. As part of this Agreement, BCBSNE and THE GROUP may agree to waive Covered Person cost sharing for care coordinator fees.
Value-Based Programs under Negotiated Arrangements. If Anthem has entered into a Negotiated Arrangement with a Host Blue to provide Value-Based Programs to Members, Anthem will follow the same procedures for Value-Based Programs administration and Care Coordination Fees as noted above.
Value-Based Programs under Negotiated Arrangements. If Claims Administrator has entered into a Negotiated Arrangement with a Host Blue to provide Value-Based Programs to Employer’s members, Claims Administrator will follow the same procedures for Value-Based Programs administration and Care Coordination Fees as noted in the BlueCard Program section. Exception: For negotiated arrangements, when Control/Home Licensees have negotiated with accounts to waive member cost sharing for care coordinator fees, the following provision will apply: As part of this agreement, Claims Administrator and Employer may agree to waive member cost sharing for care coordinator fees.
Value-Based Programs under Negotiated Arrangements. If BCBSM has entered into a Negotiated National Account Arrangement with a Host Blue to provide Value-Based Programs to Enrollees, BCBSM will follow the same procedures for Value-Based Programs administration and Care Coordination Fees as noted in the BlueCard Program section.
Value-Based Programs under Negotiated Arrangements. If BlueCross has entered into a Negotiated Arrangement with a Host Blue to provide Value-Based Programs to Members, BlueCross will follow the same procedures for Value-Based Programs administration and Care Coordinator Fees as noted in the BlueCard Program section. As part of this Agreement, BlueCross and Employer may agree/have agreed to waive Member cost sharing for care coordinator fees.