Accreditation of Case Management for LTSS (LTSS-only Plans)

It is becoming increasingly important for organizations to demonstrate their ability to effectively coordinate services between caregivers, individuals, LTSS providers and clinicians. Organizations coordinating LTSS should implement best practices for person-centered care planning and effective care transitions, and for measuring quality improvement to support people living optimally in their preferred setting.

NCQA’s Accreditation of Case Management for LTSS helps support health plans that coordinate LTSS and do not provide medical/behavioral services. The standards can support your organization in meeting the state needs.

A QUALITY IMPROVEMENT FRAMEWORK

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.

The program evaluates organizations in areas such as:

• Conducting comprehensive assessments.
• Managing care transitions.
• Performing person-centered assessments.
• Planning and managing critical incidents.
• Measurement and quality improvement.

How does this Accreditation help my organization?

Earning NCQA Accreditation of Case Management for LTSS can help organizations:

• Become more efficient. A focus on coordinated care, training and measurement can help organizations reduce errors and duplicated services.
• Integrate care better. Standards can help organizations improve communication between individuals, caregivers, providers, payers and other organizations that coordinate care.
• Provide person-centered care. Standards focus on person-centered services, which can lead to better care planning and monitoring.
• Support contracting needs. Standards align with the state needs. NCQA-Accredited organizations demonstrate that they’re ready to be trusted partners in coordinating LTSS services.