Improving LTSS Quality in KanCare: Challenges and Strategies
Discover the challenges and strategies in enhancing Long-Term Services and Supports (LTSS) quality within KanCare. Explore the transitions to managed care, implementation hurdles, changes to quality processes, and planned improvement cycles.
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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 State transitions almost all Medicaid Fee-For- Service populations and services into a managed care program, KanCare 2013 I/DD Waiver services included in KanCare as of February 2014 2014 State is implementing new contracts with MCOs to deliver services, including LTSS State revised KanCare Quality Strategy to include a greater focus on LTSS 2017-18 August 1, 2018 2
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 3
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 4
Planned Annual Cycle for LTSS Quality Improvement Annual Goal Setting Stakeholder Reporting MCO Operational Monitoring Performance Measurement (Including NCI and NCI-AD) Updates to Provider Licensing and Certification Criteria MCO Quality Improvement Initiatives August 1, 2018 5
Planned Quality Measurement and Improvement Process Define Performance Metrics and MCO Quality Improvement Initiatives Develop and Implement Changes for Subsequent Period Implement Quality Improvement Initiatives Review and Analyze Quality Initiatives August 1, 2018 6
Questions? August 1, 2018 7
