The percentage of long-term services and supports (LTSS) organization members 18 years of age and older who have documentation of a comprehensive LTSS assessment in a specified time frame that includes documentation of core elements. The following rates are reported:
- Assessment of Core Elements. Members who had a comprehensive LTSS assessment with 9 core elements documented within 90 days of enrollment (for new members) or during the measurement period (for established members).
- Assessment of Supplemental Elements. Members who had a comprehensive LTSS assessment with 9 core elements and at least 12 supplemental elements documented within 90 days of enrollment (for new members) or during the measurement period (for established members).
Why It Matters
The 2016 Medicaid and CHIP Managed Care Final Rule (CMS 2390-F) requires state Medicaid organizations operating LTSS programs to implement mechanisms for identifying, assessing and producing a treatment plan for an individual with special health care needs [1]. These organizations must make a best effort to conduct an initial screening of each enrollee’s needs within 90 days of the effective date of enrollment for all new enrollees, including subsequent attempts if the initial attempt to contact the enrollee is unsuccessful.
LTSS organizations must implement mechanisms to comprehensively assess each enrollee as needing LTSS or having special health care needs to identify any ongoing special conditions of the enrollee that require a course of treatment or regular care monitoring.
Historical Results – National Averages
Performance results for this measure are currently unavailable.
References
- Centers for Medicare & Medicaid Services. May 6, 2016. “Medicaid and Children’s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered.” Federal Register 81, no. 88: 27497–901. https://www.federalregister.gov/d/2016-09581
