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Assessing the Capacity of HCBS Providers: Key Considerations for Health Plans
Home and community-based services (HCBS) encompass a broad range of services and supports designed to help older adults and people with disabilities live in their homes and communities rather than in institutional settings. If your health plan operates in states
[...]Published Date: April 15, 2019 -
Contracting with Health Plans: Key Considerations for Behavioral Health-Focused LTSS Providers
Many states are implementing managed long-term services and supports (LTSS) for their Medicaid populations, including those experiencing mental illness, addiction, or intellectual and developmental disabilities. For this reason, health plans in your area may be seeking providers who can deliver
[...]Published Date: April 15, 2019 -
Identifying & Engaging Behavioral Health-Focused LTSS Providers: Considerations for Health Plans
As your health plan becomes engaged with persons eligible for both Medicare and Medicaid – particularly those with behavioral health needs, developmental disabilities, or substance abuse challenges – you may find it necessary to provide behavioral health long-term services and
[...]Published Date: April 15, 2019 -
Key Contract Components: Considerations For Providers
More states are contracting with health plans to manage Medicaid long-term services and supports (LTSS). As a result, you may find yourself working with health plans instead of the state to provide care for your Medicaid clients. Contracting with a
[...]Published Date: April 10, 2019 -
Contracting With Health Plans: Key Considerations For Providers
Many states are implementing managed long-term services and supports (LTSS) to better coordinate care for Medicaid recipients. This may change the way your organization provides Medicaid services by requiring you to contract or enter into an agreement with one or
[...]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 -
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