LTSS: Understanding Services for Elderly and Individuals with Disabilities to Address Living Needs

Module Description

America is experiencing the “gray tsunami.” By 2030, nearly 20 percent of the US population will be over age 65. Due to increasing medical technology, more individuals with developmental disabilities and special needs children are living longer and in more independent settings. The convergence of medical care and long-term services and supports for these patients poses significant challenges for individuals, families, clinicians, health systems, and payers. This module describes the current system of providing long-term services and supports (LTSS) for these individuals with special focus on Medicaid (the primary payer for LTSS) and safety-net providers. The discussion provides a roadmap for clinicians and health systems to effectively navigate LTSS systems and integrate LTSS and medical services to enhance care outcomes and manage costs.

Intended Audience

This course is designed for physicians as well as nurse practitioners, physician assistants, and allied health professionals who are working toward population health management, especially in safety-net settings.

Duration and Fee

Estimated Time to Complete: 1 hour

Registration Fee: $20

CME Credits

This Enduring Material activity, Population Health in the Safety Net, has been reviewed and is acceptable for up to 12.00 Prescribed credit(s) by the American Academy of Family Physicians. AAFP certification begins 10/01/2018. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty

Karen Brodsky has over 30 years of experience in healthcare policy and management. Before joining HMA, Karen served as chief of managed care contracting for the State of New Jersey’s Department of Human Services, Division of Medical Assistance and Health Services. There she had contractual, policy, regulatory, and operational leads of a $5 billion Medicaid managed care contract serving over 1.2 million enrollees. Karen chairs HMA’s Long-Term Services and Supports (LTSS) Workgroup and works closely with health plan, state, provider, and community-based organization clients on long-term care initiatives. Karen brings her extensive experience in LTSS and medical integration to this discussion to demonstrate how clinical leaders can successfully navigate LTSS system to enhance population health.

Karen Brodsky discloses that she is an employee of Health Management Associates, a national research and consulting firm providing technical assistance to a diverse group of healthcare clients.

Learning Objectives

At the completion of the course, attendees will be able to:

  • Define LTSS including the population served and the types of LTSS services available
  • Identify the factors contributing to the growth of LTSS
  • Describe how health systems identify individuals who need LTSS
  • Identify strategies states have used to shift more LTSS delivery to home and community-based settings from institutional settings
  • List activities that occur during care coordination for people receiving LTSS
  • Describe the roles of clinical leaders in LTSS