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Working With States Focused On Improving Community-Based Long-term Services and Supports: IAP’s Incentivizing Quality and Outcomes Activities

In April, we began working on the Incentivizing Quality and Outcomes component of IAP’s Community Integration through Long-Term Services and Supports (LTSS) program area. We will use IAP to increase states’ understanding of how to use incentives to improve the quality of care and outcomes provided to Medicaid beneficiaries accessing community-based LTSS. Admittedly, there are more examples of quality incentives in nursing home programs then there are in community-based LTSS services – but this is what makes our work with these states so important. Building off of delivery system and payment reform efforts already underway in many states, IAP will be a great opportunity for states to design, develop, and implement incentive strategies for their community-based LTSS Medicaid populations. We also plan to leverage national payment reform activities as part of our discussions with states around challenges in designing incentive strategies (e.g. access to data, standardized measurement, provider/plan engagement, etc.). 

We are working with states in two sequential six-month tracks, focused on planning and implementation, respectively. For the first track, we are working with nine states (IN, MD, MS, NC, NE, NV, OH, PA, VA) and will explore the types of elements needed for developing an incentive strategy such as goal setting, engaging stakeholders, identifying measures, defining the incentive structure, and monitoring the effectiveness of the incentive. For the second track, which begins in September 2016, we will provide more individualized support to three states (NJ, WA, MA) in the early stages of implementing community-based LTSS incentive activities.

Exploring these topics in the context of community-based LTSS services will be challenging, but we hope to have more answers than questions at the end of our work with these states. As is the case with all IAP initiatives, we will cull lessons learned to share broadly with all states. To learn more about the IAP’s community base LTSS work, please visit the IAP website.

IAP Commentary
Melanie Brown, IAP CI-LTSS Lead and Technical Director, Division of Community Systems Transformation, Disabled and Elderly Health Programs Group, CMCS
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