Managed Care

This paper discusses the long-term services and supports landscape; individuals who work with a direct service worker; the direct service worker profession; the direct service worker shortage; challenges for individuals served by direct service workers; and pathways to improvements.

This paper provides direct insights from managed care leaders about family caregiver supports and provides examples of how progressive managed care plans are supporting family caregivers who are caring for plan members with LTSS needs. The paper discusses how it is important to understand and address family caregivers’ roles and their needs in order to have a high-performing LTSS system, because the family provides the lion’s share of LTSS to people who need help.

This fact sheet outlines strategies to help Medicaid stakeholders encourage partnerships between community-based organizations and health care organizations. States can provide: (1) financial support to build and sustain program capacity; (2) assistance in identifying metrics for evaluation; (3) incentives to providers to address social determinants of health; and (4) use of policy levers, including value-based contracts, managed care organization regulations, and state plan amendments.

This issue brief from the Kaiser Family Foundation discusses four key issues related to long-term services and supports (LTSS), including institutional and home and community-based services (HCBS) quality, highlighting major legislative and policy changes over the last 30 years. The brief also includes data about LTSS providers and consumers, summarizes key federal laws and policies related to quality, and lists selected federal quality measures.

Presentation from the Aging and Disability Business Institute that provides practical strategies that can enable CBOs to establish positive working relationships with physician groups, hospitals and health plans.

This readiness assessment tool guides your organization through the process of successfully preparing for, securing and maintaining partnerships with the health care sector, allowing your organization to assess the current readiness of your organization, while also providing a framework and resources for navigating the process successfully. Your organization will benefit most by completing this assessment tool as an organization, rather than individually.

This report provides information about Medicaid LTSS beneficiaries in 2013. The report estimates that approximately 5.2 million people received Medicaid-funded long-term services and supports (LTSS) during calendar year 2013. This data includes state-reported estimates for managed LTSS programs. 72 percent of LTSS beneficiaries received home and community-based services (HCBS), including people who received institutional services during the year.

The Eastern Virginia Care Transitions Partnership (EVCTP) is a largescale partnership including Bay Aging and four other Area Agencies on Aging (AAAs), four health systems, three managed care organizations (MCOs), and other health care and human service providers. This case study describes several topics including the service delivery model, information sharing and reporting, shared governance, success factors, and challenges.

The Disability Network Business Acumen Center holds a call or webinar on a monthly basis with partners concerning topics of interest to those who work in the field. Notes, PowerPoint presentations, and an audio recording from each call can be found here.

Presentations from the 2014 National Home and Community Based Services (HCBS) Conference.