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.
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