Long Term Services and Supports (LTSS) Quality in KanCare

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Presentation transcript:

Long Term Services and Supports (LTSS) Quality in KanCare Brad Ridley, Director of Operations August 1, 2018

LTSS in Managed Care 2013 State transitions almost all Medicaid Fee-For-Service populations and services into a managed care program, KanCare 2014 I/DD Waiver services included in KanCare as of February 2014 2017-18 State is implementing new contracts with MCOs to deliver services, including LTSS State revised KanCare Quality Strategy to include a greater focus on LTSS August 1, 2018

Implementation Challenges Lack of established standardized and meaningful managed care focused LTSS performance measures nationally and within KanCare. KanCare program evaluation and outcomes heavily focused on physical health Limited meaningful stakeholder engagement related to quality monitoring and performance improvement August 1, 2018

Changes to MLTSS Quality Process Effective 1/1/19: Changes to KanCare1115 Waiver quality strategy to ensure appropriate emphasis on LTSS Effective 1/1/19: Added new LTSS focused measures to Managed Care Organization (MCO) Contracts Engaging LTSS Stakeholders over past year to identify priority quality metrics from existing data sources including NCI and NCI-AD Focus on external reporting to stakeholders, legislature and public to include meaningful LTSS measures August 1, 2018

Planned Annual Cycle for LTSS Quality Improvement Annual Goal Setting MCO Operational Monitoring Performance Measurement (Including NCI and NCI-AD) MCO Quality Improvement Initiatives Updates to Provider Licensing and Certification Criteria Stakeholder Reporting August 1, 2018

Planned Quality Measurement and Improvement Process Define Performance Metrics and MCO Quality Improvement Initiatives Implement Quality Improvement Initiatives Review and Analyze Quality Initiatives Develop and Implement Changes for Subsequent Period August 1, 2018

Questions? August 1, 2018