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Long-Term Services and Supports (LTSS) Quality Measures

CMS is the measure steward for nationally standardized LTSS quality measures for states with managed care and/or fee-for service (FFS) delivery systems. The MLTSS and FFS LTSS measures are aligned pairs, collectively referred to as LTSS quality measures, with unique technical specifications focused on MLTSS and FFS delivery systems.

The LTSS quality measures are grouped into three categories: assessment and care planning, falls risk assessment and rebalancing and utilization.

Assessment and Care Planning Quality Measures

Falls Risk Screening Quality Measure

LTSS Rebalancing and Utilization Quality Measures

The Measures Technical Specifications and Resource Manual contains eight quality measures for states to consider when using MLTSS and FFS delivery systems.

The Medicaid MLTSS-4 Value Sets include the lists of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), SNOMED, and Uniform Billing (UB) codes, and HEDIS© value sets, used to calculate the Medicaid LTSS Reassessment/Care Plan Update After Inpatient Discharge measure.

The Medicaid MLTSS-6, MLTSS-7, and MLTSS-8 Value Sets include the codes to calculate MLTSS-6: Medicaid LTSS Admission to a Facility from the Community, MLTSS-7, NQF 3457: Medicaid LTSS Minimizing Facility Length of Stay, and MLTSS-8: Medicaid LTSS Successful Transition After Long-Term Facility Stay.

LTSS Risk Adjustment Tables include the coefficients (model weights) for each risk factor and the mapping of the diagnosis codes to the risk factors.

For LTSS Quality Measures technical assistance, please email MLTSSMeasures@cms.hhs.gov with questions and requests for support.

Resources

MLTSS Quality Measures FAQs (March 2019): Frequently asked questions provide additional information and address common questions about the eight MLTSS measures.

Comparing the Quality of MLTSS Plans (August 2018) CMS presented a webinar about the following measures:

  • Comprehensive Assessment and Update (MLTSS-1)
  • Comprehensive Care Plan and Update (MLTSS-2)
  • Shared Care Plan with Primary Care Provider (MLTSS-3)
  • Re-Assessment/Care Plan Update After Inpatient Discharge (MLTSS-4)

Quality Measures of LTSS Rebalancing and Utilization for State Medicaid Agencies and Managed LTSS Plans (May 2019) CMS presented a webinar about the following measure

  • Admission to a Facility from the Community (MLTSS-6)
  • Minimizing Facility Length of Stay (MLTSS-7)
  • Successful Transition After Long-Term Facility Stay (MLTSS-8)

Additional information is available on LTSS Measures.