By Steve Syre
Community Catalyst offers online resource to help shape managed care policies.
Community Catalyst, a national consumer health advocacy organization, has released a new online tool for consumer advocates and other stakeholders focused on long-term services and supports (LTSS) provided by Medicaid managed care organizations (MCO).
Twenty-four states are contracting with MCOs to deliver LTSS for at least some Medicaid beneficiaries. Community Catalyst said it developed the new tool to help advocates and stakeholders maximize the potential benefits of managed care and minimize the risks of providing LTSS in that manner.
“At its best, managed care could expand access to quality community-based services and provide more efficient and coordinated care,” Community Catalyst said. “But there are big risks for consumers if states or MCOs use managed care to cut services, squeeze out community providers, or medicalize support services.”
The tool draws from federal guidance, states’ promising practices, and advice from stakeholders, including Community Catalyst and agencies serving people who are aging and/or have disabilities.
The tool provides information and resources in 9 sections covering areas such as adequate planning, consumer support and protection, overall quality, and oversight. Each of the tool’s sections provides a set of criteria for assessing and shaping a state’s program, matched with examples of best practices, policies, or contract language associated with implementing the criteria.