Based on the DHFS' "preliminary views" on LTC redesign, the Department strongly desires to utilize MCOs as the primary vehicle to deliver LTC in the future. That being the case, WAHSA advocates that all MCOs participating in the State's redesigned LTC program must have:
Again, the LTC Managed Care Organization Program would operate in accordance with the "Common Core Elements" identified in this paper. WAHSA assumes any entity (not-for-profit, for-profit, or governmental) which is able to meet the requirements listed above and adhere to the common core elements could be an MCO under the state program. Enrollment in a LTC MCO would become mandatory only if there are at least two MCOs within a client's community which offer services to that client group. Otherwise, enrollment would be strictly voluntary. In these instances, the client either could utilize the voucher option or participate in the fee-for-service system (presumably this system would offer fewer service options). Within the MCO program, enrollees generally would be free to choose a care/service plan if the cost of this plan does not exceed the client's capitation rate (determined by the client's individualized comprehensive assessment).
WAHSA 204 South Hamilton Street Madison, WI 53703
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