Guidehouse works with the federal government, state agencies, providers, and health plans across the country to address the challenges associated with long-term services and supports (LTSS) and the transformation of LTSS program design and payments. We assist clients to develop coordinated LTSS programs that are responsive to the needs of stakeholders improve quality and outcomes for individuals who are aging, and children and adults with physical, intellectual or developmental disabilities, and others.
Our experienced professionals provide solutions that tackle critical issues for state policymakers. Our multidisciplinary expertise enables us to develop innovative and effective solutions across the continuum of care. Our solutions include:
Managed Care for LTSS We assist with program design, stakeholder communications, and waiver and procurement document developments to help states choose health plans. We also provide implementation support, including readiness assessment and contract management. We assist states with the development of LTSS quality metrics and oversight of programs. We provide assistance in the development and evaluation of state Programs of All-Inclusive Care for the Elderly (PACE). We partner with managed care organizations to help them develop an LTSS network and infrastructure to meet challenging regulatory requirements and provide efficient solutions for vulnerable populations.
HCBS Program Design and Rate Setting
We help states assure compliance with CMS and federal regulations. We assist with home and community-based services (HCBS) program design to incorporate concepts of person-centered planning, self-direction and conflict-free case management. We help develop rates for HCBS, working closely with stakeholders to address the unique needs of program participants, providers, financing agencies and federal requirements.
Cost Surveys We work with agencies to develop and execute cost surveys for home-, community-based and other providers unique to the program. We are known for our ability to work seamlessly with stakeholders to address their particular concerns. We apply best practices and other rate development methodologies to recommend and implement new payment models that support state goals, and achieve quality and access outcomes.
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