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Care Coordination – Tom’s Story
A person-centered approach is key in disability-competent care coordination. Care coordinators help participants with disabilities and chronic health conditions manage risk within the context of their personal preferences as well as their health and safety needs. Tom’s story demonstrates how
[...]Published Date: April 10, 2019 -
Contracting with Providers: Key Considerations for Health Plans
As more states expand managed long-term services and supports (LTSS) options, there will be new opportunities to integrate acute and long-term care. This will require plans, which may already have considerable experience contracting with acute care providers, to negotiate agreements
[...]Published Date: April 10, 2019 -
Spotlight on Keiro Northwest: Culturally Competent LTSS
Long-Term Services and Supports (LTSS) tailored to meet the cultural needs and preferences of individuals from diverse communities can improve beneficiaries’ wellbeing and care experience. Keiro Northwest is a nonprofit organization purpose-built by the Japanese-American community that now serves the
[...]Published Date: April 6, 2019 -
Oversight of Participant-Directed Services: Key Considerations for Health Plans
Adequate oversight of the delivery of personal care services in participant-directed programs is vital so that members’ individual service plans are carried out correctly and prevent fraud and abuse. However, monitoring the provision of services in participant-directed programs can be
[...]Published Date: April 2, 2019 -
Oversight of Durable Medical Services: Key Considerations for Health Plans
Health plans increasingly will be required to manage, monitor, and oversee a broader range of services as more states contract for managed long-term services and supports (LTSS). Oversight includes preventing fraud and abuse, which requires ensuring that the services billed
[...]Published Date: April 2, 2019 -
Communicating With HCBS Providers: Key Considerations For Health Plans
As more states contract for managed long-term services and supports (LTSS), health plans increasingly will be required to arrange for home- and community-based services (HCBS). Establishing a written protocol for clear and effective communication methods with your HCBS providers should
[...]Published Date: April 1, 2019 -
Monitoring the Delivery of Personal Care Services: Key Considerations for Health Plans
Health plans increasingly will be required to provide oversight for a broader range of services as more states contract for managed long-term services and supports. These services may include personal care services delivered by direct service workers (DSWs). Monitoring the
[...]Published Date: April 1, 2019 -
Oversight of Transportation Services: Key Considerations for Health Plans
Health plans increasingly will be required to oversee non-emergency transportation services as more states contract for managed long-term services and supports (LTSS). Oversight often refers to preventing fraud and abuse, which requires ensuring that the services being billed are actually
[...]Published Date: April 1, 2019 -
RIC Event: Gathering and Using Member Feedback in Plan Governance
https://youtu.be/dn0G9ZI9Dng?si=aPt0Kq5L2WlPEnFr Members participating in health plan governance can provide valuable feedback to inform plan policies and procedures that address the needs of members and their families and caregivers.1 Following two webinars on engaging members in plan governance and ways to
[...]Published Date: March 27, 2019 -
Action Plan Selection Guide – A Tool for Self-Management Support
The Self-Management Support (SMS) Action Plan Selection Guide helps behavioral health providers choose action plans that best meet the needs of their clients and their organization. Action planning is particularly useful for clients with mental illness, substance use conditions, and/or
[...]Published Date: March 18, 2019