Performance Measures in MLTSS Programs: Research Brief. Summary


MLTSS programs are using a variety of process and outcome measures to monitor their MLTSS programs. States and CMS are placing greater emphasis on member outcomes -- both person-centered as well as health outcomes. Some of these outcomes can be derived from claims/encounter data and others by directly asking the members themselves about their experiences of care. Nevertheless, there remains a role for process metrics in overseeing MCO contract compliance related to member assessment, service delivery and member protections. In concert, both types of measures allow stakeholders to gauge the effectiveness of MLTSS programs in providing needed services and supports, delivered in a manner desired by members, and which maximize members' health, functioning and quality of life.


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