To manage individuals with complex and ongoing needs—such as those with chronic illness, disabilities, or other conditions that limit their ability to function well in their daily lives—a growing number of states are turning to managed long-term services and supports (MLTSS) programs.
Improving outcomes for these complex individuals focuses on comprehensive, coordinated care characterized by interdisciplinary teams and member engagement throughout the healthcare journey. This approach delivers orchestrated, collaborative care that is highly personalized to support the unique and diverse needs of each individual while improving care quality and efficiency and reducing unnecessary costs. It also helps further a primary MLTSS goal: moving care from institutions to community- and home-based settings to give people equitable access to care and more options to live and receive services in the community.
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Whole-Person Approach Delivers Better Care
MLTSS programs require a holistic approach to improve the quality of life for complex members, a methodology that integrates primary care with other services to address medical, behavioral, and social determinants of health. Collaboration across providers, plans, and community services promotes better decision-making and reduces fragmented care, preventing unnecessary admissions and emergency department visits by addressing the root causes of health issues and providing proactive care.
InfoMC has 25+ years of experience integrating behavioral and social determinants as part of a comprehensive, whole-person approach to care. Incedo integrates care across the full continuum of medical and behavioral health providers and community services to eliminate barriers and ensure health equity for even the most complex individuals.
Fully Integrated for Maximum Efficiency
To be successful, MLTSS plans need the right information delivered to the right people at the right time and setting to more efficiently evaluate member needs, authorize and adjust services, and coordinate and deliver personalized care.
Incedo offers tight integration across care and utilization management workflows—with optional integration with end-to-end behavioral health management—enabling seamless, efficient collaboration across interdisciplinary teams. This approach ensures care continuity and consistency for your MLTSS program from assessment through authorizations, referrals, engagement, care planning, and monitoring to close gaps, smooth transitions, and improve outcomes across all populations and risk factors.
Incedo also offers a secure interoperability framework that supports integration with key systems and ensures your data is safe, complete, up-to-date, and available for reporting.
Improve Quality Reporting and Compliance
MLTSS programs require a data-driven approach to accurately monitor, measure, and improve quality performance to ensure successful health and financial outcomes. Robust data integration and reporting helps organizations make informed decisions, tailor interventions to individual needs, and track the impact of interventions over time.
Incedo aligns processes and workflows by program with regulatory guidelines—including CMS, NCQA, URAC, and state requirements—so you can proactively manage performance and ensure compliance. Highly flexible reporting is available for every data field within Incedo, enabling you to track and trend required quality measures to support improvement, accountability, and compliance. Self-serve configurability enables you to adapt to changing regulatory requirements.
Wizard Simplifies Authorization Management, Improves Accuracy
When MLTSS services are reduced, increased, or suspended, authorizations need to reflect the change. With Incedo, there is no need for manual calculations or new authorizations. Simply enter the new dates and units in the existing authorization, and Incedo does the rest—automatically calculating service quantity and length of time so only necessary and appropriate services are covered and paid for. Incedo is pre-configured to automatically generate all authorization letters required for New York state and can be customized to support other states and regions.
Ready to Learn More?
If you’re ready to learn more about how the Incedo Enterprise Care Management solution can support your MLTSS program, set up a consultation today.
