The Affordable Care Act (ACA) and other federal initiatives require development of new service delivery and financing models, including greater reliance on home and community-based care for Medicaid enrollees with long-term services and supports (LTSS) needs, rather than institutionalized care. This population includes many subgroups, including older adults, people with chronic medical conditions, people with complex medical conditions, people with intellectual or developmental disabilities, and people with acquired disabilities.
Our goal is to help states establish cohesive, person-centered policies, delivery systems and services that increase individuals’ access to appropriate, cost-effective services that promote independent living in the community as much as possible. Our interdisciplinary approach integrates expertise in health law, policy, clinical and program operations to provide our clients with the robust solutions, recommendations, and program development services needed for successful LTSS solutions in a complex health care environment.
Our expertise in helping states reform LTSS can provide public programs and health care organizations with a wide range of services to help with reforms including policy planning, program design, implementation and operation at the delivery system or individual program level. With a commitment to creating a health care system that works for everyone, our team has the following expertise:
- Data analytics to provide a complete picture of a population.
- Policy analytics and architecture: The full range of analytics needed to develop and implement strong policies and programs. Our team excels in analyzing data and interpreting results; creating payment, cost and financing models; and building legal and public engagement strategies.
- Stakeholder engagement and policy consulting
- Financing initiatives to help fund long-term care
- Care coordination for medically complex populations, including prior authorization services
- Clinical eligibility and provider network development, including credentialing for home and community-based waiver programs and providers
- Nursing facility pre-admission screening and resident reviews
- Training for providers and state staff
- Public policy: Seasoned in public policy design and reform, our team can partner with state agency leaders and project teams to build new programs in the public sector.
- Supporting state health policy leaders transform ideas into reality by crafting inventive and sustainable solutions to systemic challenges, such as implementing ACA LTSS initiatives like The Balancing Incentive Program (BIP), Money Follows the Person program, and Medicaid State Plan Amendments for Health Homes and 1915(i) services.
- Transformation facilitation: we distill complex concepts and competing parameters into understandable choices. We bring decision makers together with consumers and stakeholders to make policy that works.
TrendFinder LTSS, our long-term services and supports data analytics platform, addresses capacity planning, quality, expenditures and utilization, and program integrity. Learn how.