Managed Care

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State Standards for Access to Care in Medicaid Managed Care

The OIG report examines state standards and requirements for network adequacy and access to care. The report was based on surveys and interviews of state officials, CMS employees, and External Quality Review Organizations. In the report, OIG notes that state standards on access to care vary widely, and that state oversight of health plans also varies. Based on its findings, OIG offers recommendations to CMS in the report.

Short URL: http://www.advancingstates.org/node/65893

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Transitioning Long Term Services and Supports Providers Into Managed Care Programs

This paper identifies the concerns and considerations in transitioning traditional LTSS providers from fee-to-service models to a managed care program.The findings of the study are based on qualitative interviews conducted with a variety of stakeholders, including state Medicaid program officials, representatives from managed care companies, LTSS providers, LTSS provider associations, and private consultants.

Short URL: http://www.advancingstates.org/node/65883

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The Growth of Managed Long-Term Services and Supports (MLTSS) Programs: A 2012 Update

This white paper provides an inventory of all current MLTSS programs and a projection of future programs as of July 2012. The report includes state-by-state results and synthesizes findings across states, reporting national enrollment, characteristics of contractors and multiple program features.

Short URL: http://www.advancingstates.org/node/65881

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Strengthening Long-Term Services and Supports: A Tool to Assess and Improve Medicaid Managed Care

This tool promotes consumer-focused MLTSS by making it easier to identify weaknesses and promote better practices. The tool combines a checklist for assessing MLTSS with examples of practices, policies or contract language that implement the criteria.

Short URL: http://www.advancingstates.org/node/65878

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National Disability Policy: A Progress Report - October 2014

This report fulfills NCD’s statutory mandate to annually report and make recommendations concerning the state of disability policy in the United States. Specifically, the 2014 Progress Report focuses on seven key areas: the Convention on the Rights of People with Disabilities (CRPD), employment access and inclusion, subminimum wage, education outcomes, Medicaid managed care, mental health care, and data trends in disability policy.

Short URL: http://www.advancingstates.org/node/65846

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2014 State of the States in Aging and Disabilities

In 2014, ADvancing States surveyed state aging and disability agencies regarding the significant policy, fiscal, and operational issues occurring within each state. The survey collected detailed information about the structure of agencies, the supports provided, and the populations served by aging and disability agencies. Of particular interest is the summary of services provided in Medicaid waivers across the country. All of this information is presented in the charts accompanying this document.

Short URL: http://www.advancingstates.org/node/65688

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Participant-Directed Services In Managed Long-Term Services And Supports Programs: A Five State Comparison

At the beginning of 2013, 16 states had Medicaid managed long-term services and supports (MLTSS) plans, with mandatory or voluntary enrollment. Target populations varied by state. In 13 states, MLTSS plan members were afforded the choice to participant-direct (PD) at least some HCBS services. Based on 5 in-depth state case studies expectations regarding availability and take-up of PD services in MLTSS varied as did methods of communicating expectations. PD varied from 1.2% in AZ to 24% in NM.

Short URL: http://www.advancingstates.org/node/61410

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Checklist: How Consumer Focused Are Your State's Medicaid Managed Long-Term Services and Supports?

This checklist is designed to help consumers and other stakeholders assess state Medicaid Managed LTSS. It is based on federal guidance released in May, Community Catalyst’s paper “Putting Consumers First: Promising Practices for Medicaid Managed Long-Term Services and Supports,” and stakeholder recommendations on meeting consumers’ needs.

Short URL: http://www.advancingstates.org/node/61189

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Application of Existing External Quality Review Protocols to Managed Long Term Services and Supports

This guidance document is intended to provide guidance to states on how to apply the revised protocols for External Quality Review (EQR) of Medicaid managed care organizations, released in 2012, to managed long term services and supports (MLTSS) programs. Although the protocols already apply to MLTSS generally, this document offers specific suggestions to make their application to long term services and supports (LTSS) clearer and provides suggestions, examples and illustrations.

Short URL: http://www.advancingstates.org/node/60531

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