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LTSS and HCBS Consulting for States
Improving outcomes for individuals and states
Deloitte supports states as they manage and transform their Long-Term Services and Supports (LTSS) and Home and Community-based Services (HCBS) programs throughout all phases of planning, implementation, and operational management.
- Deloitte’s LTSS and HCBS Planning and Transformation Services
- Deloitte’s LTSS/HCBS Technology Service Offerings
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Key challenges for LTSS and HCBS programs
Millions of adults, seniors, and children need access to LTSS due to disabling conditions and chronic illnesses. HCBS programs enable individuals to remain in their homes and communities while receiving services and support.
States are focusing on four key goals for their LTSS and HCBS programs:
- Optimizing the individual’s experience
- Increasing quality of care
- Improving population health, and
- Reducing costs
In addition, states are increasingly using Managed Long-Term Services and Supports (MLTSS) to deliver care through capitated Medicaid managed care programs.
Deloitte supports states as they manage and transform their LTSS and HCBS programs throughout all phases of planning, implementation, and operational management.
Deloitte’s LTSS and HCBS planning and transformation services
- LTSS and HCBS program redesign: Our program redesign capabilities are based on a deep knowledge of LTSS and HCBS policy, innovative program design, subject matter experience, and data-driven financial analytics. We engage with key stakeholders throughout the design process to establish goals and to outline the path forward, considering internal policy and procedures, existing and future state regulations, and application processes.
- Provider network adequacy assessment: Evaluating a state’s LTSS and HCBS programs requires assessing the adequacy of the provider network to meet the needs of the LTSS and HCBS populations. We bring time-tested methods and tools to help states understand the demand for various LTSS and HCBS services, current provider networks, and current gaps. We bring solutions to address gaps based on state-specific demand and supply details.
Deloitte’s LTSS and HCBS technology service offerings
Specialized systems and processes are needed to support LTSS and HCBS programs and facilitate more ways to efficiently provide person-centered, high-quality services across settings. Consumers need easy access to services through “no wrong door” mechanisms that simplify navigating a state’s programs and supports. Case managers need tools to appropriately plan and coordinate required services, as well as to help individuals achieve their goals and improve health outcomes. At an aggregate level, state staff need information to effectively monitor whether the right people are getting the right services at the right costs.
Deloitte offers on-premise HCBS case management solutions as well as our configurable, cloud-based solution. Specific components supporting LTSS and HCBS include:
- Program and case management system (cloud and platform and custom/transfer)
Our solution(s) provides consumers, state staff, and providers a flexible and reliable platform that centralizes, monitors, and simplifies the end-to-end lifecycle for waiver beneficiaries. These solutions were designed and developed for LTSS programs with various stakeholders in mind.
- Integrated eligibility with No Wrong Door
Deloitte implements integrated eligibility capabilities for LTSS services that include integrated screening for “No Wrong Door,” eligibility and enrollment processes, and integration with managed care organizations (MCOs) for MLTSS enrollment while also aligning with HCBS Final Rule mandates.
- Electronic visit verification
We offer a flexible cloud-based solution that meets the 21st Century Cures Act mandates for an electronic verification of services provided—delivered in a manner that simplifies service delivery and billing.
- Provider network adequacy oversight
Deloitte offers a cloud-based provider network analysis and adequacy tool that is part of our Medicaid Program Oversight Portal (MPOP). This tool supports analysis and network adequacy of both LTSS and HCBS provider networks and health care provider networks.
- MLTSS oversight analytics
Deloitte’s MLTSS Quality Portal is an integrated solution to support state oversight of MLTSS programs. It combines data from internal state systems with standardized LTSS data sets from MCOs and enrollment brokers to perform multiple analytical analyses and visualizations.
Changes to Medicaid eligibility in 2018
Winning the shift from volume to value