Indiana Family and Social Services Administration

Prior to the COVID-19 pandemic, Indiana hosted stakeholder workgroups to identify needed improvements to its Medicaid-funded long-term services and supports (LTSS) system. The pandemic further amplified existing disparities, including inequitable access to community-based care, unaligned and uncoordinated care for dually eligible individuals, and broad gaps in capacity and resources to effectively oversee and implement the LTSS reform effort.

Project Purpose

With support from Arnold Ventures, Indiana’s Family and Social Services Administration (IN FSSA) is working with project partners to: (1) design a Medicare-Medicaid integration strategy for dually eligible individuals enrolled in Medicaid managed long-term services and supports (MLTSS); and (2) engage providers in its development process, provide educational support to ensure they understand the model, and support them in enrolling as participating providers in relevant MLTSS plan networks.

Project Approach

To achieve project objectives, IN FSSA is undertaking a 33-month effort as part of broader LTSS reform activities that will include:

• Developing a comprehensive LTSS reform plan with a focus on integration of Medicare and Medicaid. IN FSSA is contracting with Speire Healthcare Strategies for strategic coaching and consultative services to support development of a comprehensive LTSS reform plan. This plan will include: (1) mechanisms to align Medicaid MLTSS plans with Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) for dually eligible individuals; (2) a stakeholder engagement strategy; and (3) strategies for provider rate development that focus on quality, outcomes, and sustainability.
• Providing support and building capacity for providers of home- and community-based services. In addition to provider engagement for LTSS reform plan development, Indiana is contracting with ADvancing States for additional educational support to LTSS providers to ensure their sustained success in the transition to MLTSS. Provider education will include technical assistance on how to successfully navigate risk-based managed care and enroll in relevant provider networks. Though a wide range of providers will be engaged in this process, there will be an added focus on providers of home- and community-based services who disproportionately serve people of color and individuals in rural communities to ensure more equitable access to LTSS across the continuum of care for all Hoosiers.

Support for Other States

Many states are in the same position as Indiana — they know they want to improve care for their dual-eligible populations by providing fully-integrated programs, but face resource gaps that prevent them from moving forward. Arnold Ventures launched the Advancing Medicare & Medicaid Integration initiative to support states and help fill those resource gaps. Learn more about funding opportunities.