In 2017, 1.8 million individuals received long-term services and supports (LTSS) through Medicaid managed care plans.1 As the number of people needing LTSS continues to rise, many states have moved toward value-based payment arrangements. With the emphasis on value over volume, managed care organizations and home and community-based organizations are expected to demonstrate their ability to coordinate medical and social services for the people they serve. In addition, states increasingly require organizations to be accredited, to receive Medicaid reimbursement. 2,3
NCQA’s LTSS Best Practices Academy
This is where NCQA’s LTSS Best Practices Academy comes in: to share best practices about managing LTSS and quality improvement as organizations develop capabilities for taking on these functions and preparing for accreditation. The Academy is an interactive forum for professionals to discuss strategies for coordinating quality LTSS programs.
With over 155 participants from more than 50 organizations, the Best Practices Academy supports organizations that are committed to providing quality, person-centered care. It fosters informative discussions and enriches information exchange through its SharePoint website, One Pagers, webinars and one-on-one discussions.
At a recent Academy webinar, Erin Giovannetti, Senior Research Scientist at NCQA, discussed the approved 2019 LTSS-specific HEDIS measures (for measurement year 2018). These measures were developed by NCQA with our partner Mathematica Policy Research, under a contract from CMS. They align with current LTSS standards and focus on:
- LTSS Comprehensive Assessment and Update.
- LTSS Comprehensive Care Plan and Update.
- LTSS Shared Care Plan with Primary Care Practitioner.
- LTSS Reassessment/Care Plan Update After Inpatient Discharge.
Although the mechanics of data capture and reporting are up to individual agencies, the desired outcome is to raise the bar on service quality and improve the health care experience for LTSS care recipients.
Join the Academy!
Future Best Practices Academy webinars will focus on measurement and outcomes, social determinants of health and patient-centered/patient-driven health care. As Academy members, LTSS providers and coordinators recognize the importance of rising to the challenge of demonstrating the delivery of high-quality health care.
The 2018 Academy enrollment period has ended. Email firstname.lastname@example.org to receive communications regarding the 2019 Academy.
- 2018 MACPAC Report to Congress. https://www.macpac.gov/wp-content/uploads/2018/06/June-2018-Report-to-Congress-on-Medicaid-and-CHIP.pdf
- Spotlight on States: LTSS in Action. https://blog.ncqa.org/spotlight-on-states-ltss-in-action/
- Kansas Medicaid Managed Care: Raising the Quality Bar – Includes NCQA LTSS Distinction! https://blog.ncqa.org/kansas-medicaid-managed-care-includes-ncqa-ltss-distinction/
Teresa is an NCQA LTSS Best Practices Academy facilitator and consultant to NCQA. She is also a is a registered nurse and case manager. Teresa co-authored COLLABORATE: A Universal Competency-Based Paradigm for Professional Case Management and CMSA Core Curriculum for Case Management, 3rd ed. She is a Past President of the Case Management Society of America.