LTQA Publishes Case Study on Sunflower's LTSS Integration

Date: 10/25/16

Sunflower's integration of long-term services and supports (LTSS) with medical care has been recognized as an exemplar program within a series of case studies recently published by the Long-Term Quality Alliance. LTQA aims to improve outcomes and quality of life for persons and their families who are managing functional limitations due to chronic health conditions.

The term LTSS refers to a spectrum of health and social services that support elders or people with disabilities who need help with daily living tasks. These services can be provided in the home and community or in a facility. Sunflower Health Plan, a subsidiary of Centene Corporation, is contracted by the State of Kansas Medicaid agency to coordinate care for members receiving medical services and LTSS in the managed-care program named KanCare.

LTQA published five new case studies in September as part of a larger research project titled: Key Components for Successful LTSS Integration: Case Studies of Ten Exemplar Programs. Through detailed interviews, LTQA assessed Sunflower's approach to integrating medical care and LTSS as well as the plan's impact on total health care costs, quality of life and health outcomes for members in the Medicaid managed-care program.

"Sunflower Health Plan takes a whole-person approach to coordinating care for its membership and strongly believes that people receiving LTSS reach optimum health when their medical, behavioral and community-based services are integrated," said Chris Coffey, Sunflower president & CEO. "Sunflower appreciates its involvement in the LTQA study of exemplar programs and, through the process, has gained additional insights on quality improvement for LTSS in Kansas."

"Sunflower’s program provides strong evidence of the advantages for persons with complex care needs and their families of access to a care manager and integrated care,” said Larry Atkins, executive director of LTQA.

The research project hypothesizes that LTSS integration has the potential to improve outcomes and lower overall costs of care for people with substantial functional limitations and complex care needs. This body of research is intended to inform business decisions by health plans and other risk-bearing organizations considering LTSS integration, and to contribute to policy discussions on financing LTSS.

The case study on Sunflower's LTSS integration notes that, since KanCare's launch in 2013 and the program's subsequent inclusion of services for intellectual and developmental disabilities, there have been improvements in the quality of care for recipients of LTSS as well as the processes taken on by the network of providers. Additionally, researchers point to state-level data demonstrating the improvement in access and a decrease in hospital visits for the population receiving LTSS.

Links to the LTQA research products are listed below: