Enhancing LTSS case management for state division of Medicaid
Ten years ago, The Mississippi Division of Medicaid (DOM) took drastic steps to improve the way health and human services programs are administered in the state. Demands for long term services and supports (LTSS), specifically home- and community-based services (HCBS), were growing, and the agency struggled to keep up. At the time, paperwork backlogs led to reimbursement challenges and substantial risks for program members. By implementing FEI’s case management for LTSS solution in 2013, DOM swapped cumbersome, paper-based administrative processes for a fully automated, single-entry point website to manage its Medicaid waiver programs. Since then, thousands in the state have benefitted from improvements in the delivery of home- and community-based care.DOM manages health and human services programs that benefit approximately 800,000 individuals every year. Within this operational footprint, DOM is responsible for administering five areas of the state’s Medicaid program, which in 2019 served 22,932 members and supported 12,808 on waiting lists.
Facilitating the delivery of care and services to these populations is no easy feat. Especially when in the not-so-distant past DOM relied on manual processes for enrolling and recertifying beneficiaries for waivers. Not only that, data for state and federal reporting often had to be collected from multiple agencies—even for the same waiver—creating significant delays.
Our flexible case management system supports conflict-free case management policies and a core standardized assessment (CSA) across DOM waivers. Throughout our partnership with the state, our comprehensive case management solution for LTSS has increased service capacity, enhanced delivery of services and plan of care compliance and improved outcomes for members and their families in the state.
Using our platform, DOM generates data for state and federal reporting requirements and produces performance measures for benchmarking system improvement all in one place. Audit activities have also been streamlined as case management documentation review can occur right in our LTSS solution.
DOM recently extended FEI’s contract to perform significant system enhancements and assist in
CMS certification of the platform. When certification is achieved, the state will have the opportunity to receive enhanced federal match for the software.
A new partnership
To further enhance our case management solution for the state, FEI Systems recently partnered with HHAeXchange. HHAeXchange will manage our electronic visit verification (EVV) platform that connects payors and providers across the state. EVV is essential for verifying services are provided at the right place and time to the correct program member. Enhancements to our EVV will allow for greater visibility and transparency as DOM monitors network performance and quality of care across waiver programs. Together with HHAeXchange, we can continue to serve DOM in their case management needs and look forward to furthering innovation in the delivery of care.
