MLTSS Update

June 30, 2016

Our most recent post about the Managed Long Term Services and Supports (MLTSS), several months ago, described DMAS’s intent to exclude the long-term care services (those included in the ID/D Waivers) from the current initiative while including the primary and acute medical services for the ID/D population.

In the six states currently using managed care for this population for LTSS there are a variety of arrangements for acute/primary care with no assurance that the services will be integrated or coordinated.  Virginia is beginning the process of recruiting Managed Care organizations for the acute/primary care for ID/D individuals and it seems critical that we now establish the role, especially of the residential providers, to be a pro-active member of the team to assure that the managed care organizations are collaborative, respectful and knowledgeable of the role played by the Waiver service providers.

To that end we have been meeting with representatives of the “health plans.”  Our intent is to open a dialog so that, if the plan is awarded the contract in one or more of the Regions, we will be in a position to introduce our member organizations who are Residential providers and to assist in structuring a productive relationship.  We view the relationships possible under the contracts to be awarded to health plans at the end of this year to be tremendous opportunities for the individuals we support and the providers who support them.

This will be a significant topic of conversation at our Conference in the Fall!