Assessing Members’ LTSS Needs: Key Considerations for Health Plans

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More states are relying on managed care organizations to coordinate long-term services and supports (LTSS). If your health plan provides managed LTSS, it will need to contract with appropriate providers so that the full range of Medicaid services covered in the state are available to your plan’s members. These services may include both institutional and non-institutional based services, for example, chore or homemaker services, personal care, meals, or transportation. It is important to work closely with your state to clearly define your plan’s role in assessing and managing members’ home and community-based services (HCBS) needs as well as providing services. This brief provides key considerations for assessing HCBS needs and creating person-centered service plans for your plan’s members.

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