Managed Care

Presentation from the 2017 HCBS Conference on "Compliance Isn’t Quality: Building an Authentic Quality Framework in Managed Long-Term Services and Supports Programs".

This report examines state and federal oversight of assisted living services in Medicaid. Individuals receiving long-term care services from Medicaid in community residential settings is expected to grow. This report describes state spending on and coverage of these services; describes how state Medicaid agencies oversee the health and welfare of beneficiaries in these settings; and examines the extent that CMS oversees state Medicaid agency monitoring of assisted living services.

The Government Accountability Office (GAO) examined states’ needs assessment processes for provision of long-term services and supports. GAO studied six states that differed in the following ways: assessment tools in use, participation in federal initiatives, HCBS delivery systems, and geographic location. GAO also reviewed federal requirements and documents and interviewed CMS officials and stakeholders.

In this presentation, the National Committee for Quality Assurance (NCQA), shared insights from its research on person-centered goals for people with complex care needs and tools for CBOs to become more effective partners with health plans, including how to effectively measure quality improvement and implement quality improvement initiatives.

During this webinar, a panel of experts provide real-world strategies that CBOs can use to effectively expand access to their services, work with state Medicaid programs, contract with managed care, and ensure sufficient reimbursements.

The aim of this study was to gather information to gain a better understanding of the resources and assistance needs CILs may have with the new WIOA implementation guidelines in effect.

This webinar is presented by Mark Regan and Todd Swanson from the Law Offices of Hooper Lundy & Bookman PC. Their practices are dedicated to the representation of healthcare providers and suppliers.

The Center for Health Care Strategies (CHCS) and Manatt Health has developed a new toolkit that provides a targeted menu of long-term services and supports (LTSS) reform strategies adopted by state innovators that may be replicated by other states. The toolkit identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance their LTSS reforms.

Building Complex Care Programs: A Road Map for States is a guide for state leaders in establishing and advancing complex care programs. This guide from the National Governors Association Center for Best Practices (NGA Center) Health Division includes lessons learned from their work with states and effective practices gleaned from multiple pioneering state and local complex care initiatives.

This course, which consists of five (5) distinct segments for easy viewing, provides the rigorous yet practical approaches to pricing long-term services and supports. For many of organizations selling their services in order to generate maximum net income is an unfamiliar activity. However, there are many pricing models and approaches that have been deployed in other sectors from which CBO’s can learn. This course teaches profitable commercial pricing strategies.