States with Medicaid managed long-term services and supports (MLTSS) programs can use information on enrollees’ functional status – such as the ability to perform various activities of daily living (ADLs) — to determine the need for services and supports and potentially to adjust the capitation rates paid to managed care plans. To do this, states need information that is complete, objective, accurate, and timely. The state of Tennessee has a robust approach to collecting and validating functional assessment data that can help other states to advance strategies for MLTSS program rate setting. This brief, supported through the West Health Policy Center, describes how TennCare — Tennessee’s Medicaid agency — collects and validates data on enrollees’ functional status.
Trust but Verify: Tennessee’s Approach to Ensuring Accurate Functional Status Data in its Medicaid Managed Long-Term Services and Supports Program
Funder: West Health Policy Center