Long-term Services & Supports
Millions of people who are aging or have disabilities thrive in the community with the help of individualized long-term services and supports (LTSS). We partner with state agencies, nonprofits, and managed care organizations to develop and implement a range of well-coordinated, person-driven, accessible, culturally sensitive, and effective LTSS programs, supporting individuals’ quality of life.
What Challenges You
Navigating the complex LTSS system—funded primarily by Medicaid—can be challenging for individuals and their families, who often need access to an array of community-based services across multiple providers to live independently. This applies whether someone transitioning to a community living environment from a nursing home or residential care facility or needing additional supports so they can remain in their community.
In response, Medicaid agencies and healthcare organizations need to provide resources and expertise, such as experienced clinicians and navigators who understand LTSS, so members and patients get what they need to live—and thrive—independently.
Why Choose Us
We are one of the only organizations that provide such a complete range of LTSS-supportive services to our clients, including facilitating and streamlining eligibility. Led by registered nurse case managers, our multidisciplinary clinical team partners with government agencies, nonprofits, and managed care organizations to help their members and patients access LTSS. With a person-centered approach, we work to understand the services medically complex children and adults require, then coordinate service delivery so they receive skilled care in clinical settings or in the community.
How We Can Help
1We facilitate and streamline eligibility for and access to LTSS through consultation services, in-person clinical eligibility assessments and determinations, service coordination, case management, and quality care assurance.
2Our services promote choice, independence, and quality of life with monitoring, appropriate settings, and access to care.
3We offer consistent and accurate decision-making by clinical assessors across all disciplines— service coordination, disease management, and complex case management—reducing medical loss ratio through appropriate authorization of medically necessary services.
Empowering Independence in the Community
Since 2003, our teams have partnered with one state’s Medicaid agency to provide over 23,500 clinical eligibility assessments and service coordination to over 2,600 medically complex individuals who reside in facilities and want to return to the community and for those already residing in the community who require intensive LTSS. We have processed over three million claims to ensure individuals have access to the services they need. Additionally, eligibility assessments for those individuals residing in the community and applying for community-based services begin within one business day of referral. For those transitioning from facilities, more than 2,800 have successfully transferred to the community.