LTSS Consulting for States

Key challenges for LTSS programs

Older adults and people of all ages with disabilities receive LTSS due to aging, physical, cognitive, developmental, and/or other chronic health conditions. LTSS is typically delivered in three types of settings: home and community, facilities, and integrated settings. LTC programs offer services and supports in a nursing facility or similar environment. HCBS programs provide individuals with services and supports, promoting independence and the ability to remain in their homes and communities.

States are focusing on four key goals for their LTSS programs:

• Optimizing the individual’s experience
  

• Increasing quality of health and quality of life
  

• Improving population health and outcomes

• Reducing costs

In addition, states are increasingly using Managed Long-Term Services and Supports (MLTSS) to deliver care and services through capitated Medicaid managed care programs.

Deloitte supports states as they manage and transform their LTSS programs throughout all phases of planning, implementation, and operational management.

Deloitte’s LTSS planning and transformation services

• LTSS program redesign: Our program redesign capabilities are based on a deep knowledge of LTSS 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 programs requires assessing the adequacy of the provider network to meet the needs of the LTSS populations. We bring time-tested methods and tools to help states understand the demand for various LTSS services, current provider networks, and current gaps. We bring solutions to address gaps based on state-specific demand and supply details.

Deloitte’s LTSS technology service offerings

Specialized systems and processes are needed to support LTSS programs and facilitate more ways to efficiently provide human-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 include:

• Program and case management system (cloud, platform and custom/transfer)
  Our solutions provide 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.

• 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 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.