Title
Authorize the Interim Chief Executive Officer of Natividad Medical Center (NMC) to execute the Central California Alliance for Health (CCAH) no-cost Eighteenth (18th) Amendment to the Primary Hospital and Outpatient Laboratory Services Agreement to incorporate and continue the Outpatient Laboratory incentive payment for certain Healthcare Effectiveness Data and Information Set (HEDIS) 2015 Laboratory Test Results. The Agreement has been renewed automatically for successive one-year terms, subject to three termination provisions (immediate termination, termination without cause, termination with cause).
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Authorize the Interim Chief Executive Officer of Natividad Medical Center (NMC) to execute the Central California Alliance for Health (CCAH) no-cost Eighteenth (18th) Amendment to the Primary Hospital and Outpatient Laboratory Services Agreement to incorporate and continue the Outpatient Laboratory incentive payment for certain Healthcare Effectiveness Data and Information Set (HEDIS) 2015 Laboratory Test Results. The Agreement has been renewed automatically for successive one-year terms, subject to three termination provisions (immediate termination, termination without cause, termination with cause).
SUMMARY/DISCUSSION:
The Central California Alliance for Health (CCAH) is the Medi-Cal Managed Care Commission for Santa Cruz-Monterey-Merced counties. NMC provides outpatient laboratory, inpatient and outpatient services to CCAH members.
The County of Monterey, on behalf of NMC, entered into a Primary Hospital Services Agreement with CCAH with an original term of July 1, 2007 through December 31, 2007. Since then, the Agreement has been renewed automatically for successive one-year terms, subject to three termination provisions (immediate termination, termination without cause, termination with cause).
Healthcare Effectiveness Data and Information Set (HEDIS) Laboratory Test Results are a set of standardized performance measures maintained by the National Committee for Quality Assurance. HEDIS is a tool used by the majority of America's health plans to measure performance on important dimensions of care and service. CCAH offers incentive payments to contracted providers for the reporting of certain laboratory test results on a quarterly basis. The Eighteenth Amendment incorporates and continues the Outpatient Laboratory Incentive payment for the laboratory test results.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Amendment as to legal form and risk provisions. The Amendment has also been reviewed and approved by NMC's Finance Committee on 01/22/15 and by the NMC Board of Trustees on 02/06/15.
FINANCING:
There is a revenue opportunity of approximately $5,000 from this incentive program.
Prepared by: Nancy Majewski, Managed Care Operations Manager, 783-2385
Approved by: Dr. Gary Gray, Interim Chief Executive Officer, 783-2553
Attachment: Amendment No.18, Amendment No.17 through Amendment No.1, and Original Agreement
Attachments on file with the Clerk of the Board