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Long-Term Services and Supports Distinction Standards for Health Plans

NCQA’s standards provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state requirements.

Program Requirements

NCQA Long-term Services and Supports Distinction evaluates organizations in four standard areas. They include:

 

  • Core features. Organizations have processes in place for effective coordination of LTSS.
  • Assessment & implementation.
  • Person-Centered assessments & planning process.
  • Implementing the Care Planning Process.
  • Critical incident management system.
  • Qualifications and assistance for LTSS providers.
  • Program description.
  • Measurement and quality improvement. Organization measure and work to improve the members’ experience, program effectiveness and participation rates.
  • Care transitions. Organizations have a process for managing care transitions, identifying problems that cause unplanned transitions and preventing unplanned transitions, when possible.
  • Delegation. Organizations document and monitor functions performed for them by other organizations.

Getting the Distinction

Become a trusted organization for coordinating long-term services and supports. Contact an NCQA representative to learn more about the program, or purchase the 2017 MBHO Standards and Guidelines.