Long-Term Services and Supports Distinction for Health Plans

Demonstrate that your organization possesses the ability to effectively coordinate long-term services and supports (LTSS).

What Is LTSS Distinction?

NCQA’s Long-Term Services and Supports Distinction program measures whether organizations that coordinate LTSS meet certain evidence-based standards in areas such as conducting comprehensive assessments, managing care transitions, performing person-centered assessments and planning and managing critical incidents.

Who Is Eligible for This Distinction?

  • NCQA-Accredited MCOs that offer comprehensive medical benefits and manage LTSS. 
  • NCQA-Accredited MBHOs that coordinate LTSS.

Health plans that only manage LTSS are not eligible for this distinction, but can earn separate accreditation through NCQA’s Accreditation of Case Management for LTSS.

LTSS Distinction Addresses a Growing Need

  • The need for LTSS is rising. The elderly population—the largest consumers of LTSS—is growing at a significant rate, projected to more than double by 2050.[i]
  • The LTSS landscape is changing. The number of states entrusting LTSS coordination and management to MCOs continues to increase: from 8 in 2004 to 18 in 2015. [ii],[iii]
  • LTSS services must be coordinated in a person-centered, integrated manner. The Affordable Care Act mandates that states develop community-based, person-centered LTSS systems.[iv] Effective coordination among clinicians, caregivers and community providers will result in a better-served population and a reduction of duplicated efforts. NCQA Distinction in based on person-centered, integrated care.

Benefits of Long-Term Services Distinction

NCQA’s evidence-based standards:

  • Provide a framework for your organization to deliver efficient, effective, person-centered care.
  • Offer a roadmap for improvement—your organization can conduct a gap analysis to identify areas where it can improve.
  • Focus on coordinated care, training and measurement to help your organization become more efficient and reduce medical errors and duplicated services.
  • Help your organization improve communication among individuals, caregivers and community service providers.
  • Focus on person-centered services, which means better care planning and monitoring.
  • Help you demonstrate to states that your organization has the capability to effectively coordinate LTSS services.
    –    NCQA-Accredited organizations, and organizations seeking accreditation, can earn automatic credit toward accreditation if they delegate coordination of services to a partner that has earned NCQA Accreditation of Case Management for LTSS.


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