An Overview Of The IDD MLTSS Workgroup

Who Is Involved?

Sponsors of the workgroup and symposiums include CQL, The Institute on Public Policy for People with Disabilities, and Mosaic.

When Did It Start?

The first symposium was held in October 2018. The workgroup continues to meet and publish updated reports about its findings.

What Is The Project?

The workgroup is assessing value-based quality measures and providing practical guidance for managed care in the IDD LTSS field.

Why Was It Created?

Despite the expansion of Medicaid managed care, there is limited consensus on what standards should be used in the IDD LTSS.

Where Is The Impact?

There is beginning to be an expansion of Medicaid managed care into the IDD LTSS service system, with implications across the U.S.

How Does It Help The Field?

The workgroup and resulting reports provide a roadmap of key measures for supporting people to receive high quality services.

Inside The IDD MLTSS Workgroup

This collaboration involves recurring symposiums and published reports bringing together perspectives from dozens of thought leaders in the healthcare and long-term services and supports (LTSS) industry, including service providers, industry associations, managed care organizations, and other stakeholders.

Medicaid Managed Care

Medicaid managed care is a rapidly growing service delivery model in the U.S. The aim of Medicaid managed care is to reduce program costs and provide better utilization of health services through the contracting of managed care organizations (MCOs). While Medicaid managed care has existed for almost two decades, it is not frequently used for long-term services and supports (LTSS) for people with IDD.

Effect On People With IDD

As utilization of managed care for people with IDD is low, there is little research about what standards should be used for traditional as well as alternative payment models such as value-based reimbursement models. Since there is beginning to be an expansion of Medicaid managed care into the IDD LTSS system, evidenced-based quality standards and guidelines about managed care provision are critical.

IDD MLTSS Workgroup

Starting in 2018, CQL | The Council on Quality and Leadership, The Institute on Public Policy For People with Disabilities, and Mosaic organized a symposium with approximately 25 thought leaders in the healthcare and LTSS industry. Since the initial symposium, this workgroup has met a number of times to discuss quality metrics related to the expansion of Medicaid managed care into the IDD LTSS system.

Data Analysis

CQL conducted analysis in partnership with Mosaic, a faith-based organization with agencies across the United States. Mosaic provided CQL with de-identified data about the Basic Assurances®, health metrics, and incident reports from FY 2016 to 2018, and CQL independently conducted all analyses. The pilot was comprised of data from 28 service agencies who supported a total of 2,955 people with IDD.

IDD MLTSS Reports

Through insight from the symposiums held with attendees, combined with analysis conducted in collaboration with Mosaic, CQL and workgroup sponsors have produced a series of reports to detail findings, perspectives, practical steps, and other guidance and conclusions. These reports serve to ensure that evidence-based quality measures are being used to evaluate if people are living a meaningful life.

Social Determinants of Health

Medical care is only responsible for 10-15% of preventable mortality. As a result, more emphasis should be paid to social determinants of health. CQL developed a tool to measure social determinants of health, the Social Determinants of Health Index, which was also outlined in the managed care reports. This index and its findings assisted the workgroup in understanding value-based quality measures.

Symposium And Report Sponsors

CQL partnered with other sponsor organizations to create and maintain the IDD MLTSS Workgroup, and its corresponding symposiums and reports.

Institute on Public Policy for People with Disabilities

The Institute on Public Policy for People with Disabilities is a membership organization in the Illinois service delivery system.

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Institute on Public Policy for People with Disabilities

Mosaic

Mosaic serves more than 4,500 people in 11 states, with services tailored to meet individual needs and goals.

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Mosaic

"Compliance and quality are not the same. Compliance doesn't get you outcomes or get you paid."

"Start with outcomes and then determine the methods to get to those outcomes."

"Quality is not measuring things because they are easy to measure."

"We must have high expectations of people receiving supports, just like we do everyone else."

"The person receiving services must be in the driver's seat throughout the process."

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