Organizational Capacity
Coordinated Model
The coordinated model uses and maximizes the expertise of multiple units within state government to administer the MLTSS program. Minnesota’s Senior Health Options (MSHO) is a LTC product offered within the state’s primary/acute managed care program. The same managed care contractors offering the MSHO option also provide primary/acute services under Medicaid managed care. 
Functionally, MSHO operates as a business unit within the Department of Human Services by establishing the policies and standards for the MLTSS product, managing the operations unique to MSHO, and overseeing contract performance related to MSHO. In doing its work, MSHO must coordinate with other units within and outside the department, which have specialized functions related to managed care. For example, MSHO must work with licensing to ensure that the technical audits it conducts on managed care contractors address the unique needs and interests of MSHO. Similarly, the External Quality Review contract administered by the Division of Performance Measurement and Improvement must include provisions for assessing MSHO specific services and populations.
Several functions and areas of expertise are critical within the MSHO administrative unit. These include: rate setting, marketing, enrollment, policy development, contract management, service coordination, stakeholder engagement, provider relations, and capacity building. The MSHO program director plays a vital role in shaping policy, developing standards for RFPs and contracts, coordinating with the Aging and Disabilities program office on policy implications when transitioning services and populations to managed care, and designing program options within allowable federal authorities.
