ANCOR is sharing this item from last Friday’s Weekly Update as a courtesy to our members.
As written by Donna Martin, Director of State Partnerships and Special Projects:
This week I had the opportunity to participate in the annual conference of ANCOR state association member, RCPA (Rehabilitation and Community Providers Association) in Pennsylvania. They had a packed and diverse agenda, including topics on Intellectual and Developmental Disabilities, Behavioral Healthcare and Substance Use Disorders, Traumatic Brain Injury, and Managed Care.
I was invited to be part of a panel entitled, “Managed Care Quality Outcomes for I/DD Services”. In collaboration with two other presenters and our facilitator we discussed the anticipated emergence of Managed Long-Term Supports and Services (MLTSS) in the I/DD sector in PA. This state has long had managed care operating in the Healthcare and BH arena, but I/DD services have been carved out. While the state has not articulated specific plans for implementation, the stakeholder community is concerned that it may emerge suddenly and they will not be ready.
Our presentation focused on trends in quality measures in I/DD services and we shared information on the National Core Indicators, Council on Quality and Leadership and the National Quality Forum. We spoke at length about the inclusion of standard HEDIS measures (a health plan rating system on six domains of care with ninety total measures) in the healthcare and behavioral health MCO plans and the emerging expectation for plans to incorporate Social Determinants of Health into their metrics. These are life domains such as socioeconomic status, housing, education, and employment, that studies show have a significant impact on peoples overall health and wellbeing. So while I/DD services are mostly excluded from managed care, we are already working to ensure that the life factors identified as social determinants of health are attained and maintained for people supported.
While this sector continues to struggle with the adoption of a unified set of quality measures, it is important to note that there are several good resources available for organizations to consider and implement. And in the event that your state does move toward an integrated care system, you will already have a quality measurement system in place.