MDHHS Planning Process for Managed Long-Term Services and Supports

MDHHS operates three capitated programs: MI Choice home and community-based waiver, the Program of All-Inclusive Care for the Elderly (PACE) and the MI Health Link demonstration project.  Although these programs constitute managed care, they operate independently of one another rather than under the continuum of a fully integrated managed care system.

In response to the State Legislature’s FY18 and FY19 boilerplate language instructing the department to explore the implementation of a managed long-term support service system, MDHHS began an initiative to develop a plan for the eventual expansion of managed long-term services and supports (MLTSS) across the long-term care spectrum. To assist in research and analyses, and to operationalize stakeholder input, MDHHS has partnered with the Center for Healthcare Research & Transformation (CHRT) and Public Sector Consultants (PSC).  As MDHHS begins to review its current LTSS delivery system with respect to an integrated MLTSS system, it will include a careful evaluation of the coordination of services for individuals with intellectual or developmental disabilities across the LTSS and behavioral health systems.

MDHHS will examine lessons learned from other states, identify gaps in our own current LTSS system and focus on opportunities for improvement. The department will develop a plan that incorporates the Centers for Medicare and Medicaid Services’ MLTSS best practices and create an outreach plan that incorporates stakeholder and consumer input on proposed models and how a MLTSS system could be structured.

MDHHS’ guiding principles throughout this process include the concept of an integrated managed delivery system that incorporates supportive and clinical care needs. Care plans should not only be person-centered but person-driven and based upon the individual’s personal preferences and goals.  Services and supports should be tailored to positively impact an individual’s health outcomes in both institutional and home and community-based settings.

MDHHS recognizes that for MLTSS to be successfully implemented in other Medicaid programs, it is essential that we provide opportunities for feedback from consumers and engage with stakeholders. The department will seek such input throughout the MLTSS development process.

While MDHHS explores the expansion of MLTSS, consumers who currently receive LTSS will continue to receive their current services unless their eligibility changes.  Improvements to the LTSS system will take time to make, and consumers will be notified of any changes in services, if they occur.