VP, Long Term Care Services
Over 10 Million Americans with disabilities use Long-Term Services and Supports (LTSS) to assist in their self-care, engage in their community, and achieve their goals of living independently.
Medicaid is the primary funding source for most people receiving services. Each state has its’ own pathway for people to access LTSS. With increasing frequency, states are moving to Managed Care models.
The movement towards Managed Care is driven by the need to contain costs, ensure quality, and mitigate risk. Keeping enrollees central to the focus ensures that a quality management system will meet the unique needs of the population being served. Consumer engagement initiatives also allow for the understanding of quality from the perspective of the people who are being served.
Managed Care programs have long served people with disabilities. One such Managed Care program in Wisconsin is Family Care. Family Care enrollees have moved back into the community safely after spending years living in institutions, while other enrollees have achieved new levels of independence by living and working in their communities. Most enrollees can boast vast improvements in overall health. These successes are achieved by two principles that are the hallmarks of Family Care: person-centered planning and disability services expertise.
We are at a unique juncture: paralleling the movement towards Managed Care has been the growth and popularity of Participant Directed Programs. It strikes me that bridging two key aspects—person-centered planning and quality management—might result in a delivery system with improved results.
I look forward to working on just that.