To our health plan clients and other providers, ILS Managed Long Term Care provides holistic care and access to support services aimed at allowing the elderly, individuals with special needs, and dual-eligible populations to age in place through “high-touch”, “low-cost” services that address aspects of daily living and innovative systems that monitor, measure, and report care. ILS Managed Long Term Care brings care and community based services together to address critical needs that impact all aspects of daily living to the elderly, individuals with special needs, and dual-eligible populations and their families.
ILS Managed Long Term Care (MLTC) sets a new standard for complete care of the elderly, special needs and dual-eligible populations. The company’s MLTC program focuses on providing supportive care in the home and community setting. Through targeted interventions coupled with community based solutions ILS MLTC enables individuals to comfortably age in place.
The program’s first priority is helping delay or avoid nursing home placement for members, as people overwhelmingly prefer to stay in their homes as they age. Current federal and state budgets can no longer sustain widespread institutional care. ILS has developed an advanced system for measuring, monitoring, and reporting care, with tailored assessment tools and care plan metrics.
ILS provides integrated technology services designed to address the entire managed care life cycle from member enrollment to care management through provider payment and financial reporting. A series of closely coupled modules and workflows that easily integrate with third party applications make the ILS Managed Long-Term Care system an efficient, effective and turn-key approach to administering the business of healthcare.
The MLTC program is based on the principles of:
Network Development: A comprehensive network of providers is essential for all MLTC programs. The network must include providers in a variety of service industries in addition to health care providers. ILS credentials its network of MLTC providers in accordance with all regulatory requirements.
Assessment: The program’s unique assessment model is focused on providing a holistic evaluation of the member’s needs, including finances, housing, home modification, transportation and access to care. It incorporates the critical component of home visits, which enable care coordinators to get a true sense of how a member lives and his or her specific needs.
Planning: The tailored care plan takes into account health plan requirements and is designed to integrate with existing managed care models for a seamless integration of medical and social services. The plan is customized for each individual, treating their specific needs at a fraction of the cost of providing cumbersome, overarching care.
Complex Care Management: ILS provides comprehensive assessment and ongoing care management and care coordination through individualized cared plans in accordance with national regulations for Medicare and Medicaid populations.
Care Coordination: ILS identifies community services provided under the Older Americans Act and integrates them into local provider networks, helping members get the care they need at no cost to health plans. These services go beyond clinical care to address every aspect of daily living including bathing, transportation, meal delivery, and caregiver support to help meet a member’s basic needs and lay a foundation for improved overall health.
Referrals and Authorizations: To ensure that needed services are delivered, a sophisticated process of referrals and authorizations is established. The authorized services are tracked and matched to individual claims for processing. The ILS system streamlines utilization management.
Claims Processing: One of the strengths of ILS is the ability to receive and process claims in a variety of formats. While traditional healthcare providers submit claims via HIPAA compliant electronic transactions or on a CMS 1500, non-health care providers use a variety of applications and formats. In addition, providers who are working directly for members through self-directed care will submit time sheets directly to the MLTC program. ILS supports a variety of formats for proper tracking, invoicing, and payment
Reporting: ILS provides clients with unparalleled access to a full suite of reporting capabilities to help evaluate the care provided to members and associated outcomes.
MLTC was created to serve as an alternative to the current system of costly, inefficient and undesirable institution-based care. It decreases financial burden for all stakeholders – health plans, hospitals, governments, and members – by preventing or reducing costly health events that occur far too frequently in aging populations, while simultaneous helping to reduce the emotional toll of aging. To learn more, Contact Us.