State Medicaid agencies are increasingly shifting away from fragmented, fee-for-service delivery systems toward more coordinated, cost-effective managed long-term services and supports (MLTSS) programs. By 2014, it is expected that over 50 percent of states will have an MLTSS program. Uniform assessment of individuals served through Medicaid MLTSS programs can help ensure that beneficiaries’ needs are appropriately identified and services are equitably delivered.
This brief explores uniform assessment processes in five states with MLTSS programs – Arizona, Minnesota, Tennessee, Texas, and Wisconsin – to identify what uniform assessment tools are available, how they are administered, and considerations for development and implementation. The lessons from these states can help other states develop more uniform assessment processes across MLTSS programs to ensure consistent and high-quality care for beneficiaries served.
Following are five key points that states may want to consider as they develop uniform assessment processes:
- Create flexibility in MCO contracts to foster innovation and allow managed care organizations (MCOs) to best meet the needs of the populations they enroll;
- Set clear, realistic data reporting requirements beginning with core measures to be reported and adding performance measures over time;
- Build strong state-MCOs relationships that promote communication and collaboration;
- Establish meaningful stakeholder engagement to foster a partnership in shaping MLTSS programs; and
- Align Medicaid and Medicare requirements to build a streamlined and seamless process for MCOs and beneficiaries.