• Introduction and Learning Objectives
• MLTSS Basics
• Universal Features
• Program Design Choices

• Target Populations
• Enrollment
• Service Coordination
• Options for Including Medicare
• Covered Services
• Provider Networks
• Consumer-Directed Services
• Financial Incentives

• Federal Authorities
• Organizational Capacity & Competencies
• Case Studies

Service Coordination

Sample Contract Language

Below are a few examples of contract language, which highlight the varying approaches to service coordination in MLTSS programs.

• The first example is from the Massachusetts Senior Care Options contract, which highlights three different topics and approaches: (1) requiring a subcontract with a traditional service coordination agency, specifically with a group in the MA aging network, (2) providing a detailed description of the service integration and coordination expectations of the contractors, and (3) expecting service coordination to go beyond covered services.
  
  
• The second example is from the Minnesota Senior Health Options (MSHO) contract where the provisions for service coordination reflect the program’s design as a fully integrated Medicare and Medicaid product.
  
  
• The third example is from New York and highlights the state’s specific requirements for coordinating care for services and supports that are beyond those covered in the MLTSS program.
  
  
• The final example is from Wisconsin’s Family Care contract with MCOs, which requires coordination of formal, informal, health, and LTSS, regardless of whether or not those services and supports are included in the Family Care program. Contract language is also included that shows that WI expects service coordination to be member centered and a team responsibility.

 

 

 

Library Resources J. Gillespie, R. Mollica, R, Care Coordination for People with Chronic Conditions, Partnership for Solutions, Johns Hopkins University, January 2003. A. Chen, R. Brown, N. Archibald, S. Aliotta, P. Fox, Best Practices in Coordinated Care, Mathematica Policy Research, Inc under contract for Health Care Financing Administration, March 22, 2000. M. Booth, E. Griffin, Addressing Potential Conflicts of Interest Arising from the Multiple Roles of Colorado's Community Centered Boards, USM Muskie School, December 2007.

 

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