Individuals who need long-term services and supports

Through Wellpoint’s Long-Term Services and Supports (LTSS) program, we help older adults and people with disabilities live independently. We help coordinate services and supports, increase access to self-directed options, and provide members with a single point-of-contact to navigate complex systems of care.

Integrated, holisitic care

 

Our integrated, holistic approach to care incorporates the following key elements:

Person-centered care coordination

  • We bring together the right combination of health care, services, and supports while taking our members’ preferences and priorities into account. Our full-spectrum care and service coordination approach emphasizes an individualized, member-centric focus that supports self-direction, personal preference, and individual goal setting.

Guiding members through complex systems

  • Services and supports for members with LTSS needs can be confusing, so we’re here to help guide members. Our offerings go beyond health care to connect members with the resources that are right for them – so they can live better on their own terms.

Helping members thrive in the community

  • We provide members and families with resources to build, maintain, or rebuild their lives with their families and friends. These supports include access to housing, employment supports, and transportation. By coordinating LTSS, we improve the quality of care and services, eliminate barriers, and support members to live independently at home and participate fully in their communities.

Technology that raises the bar

  • We use technology to raise the bar for our overall program by integrating and sharing data to support our care management and care coordination activities. For example, through our care management system, all selected providers involved in the member’s care and services have access to the member’s clinical information and integrated care plan, facilitating communication and coordination.
  • We work directly with providers to give them access to tools and supports to engage with members and enhance their behavioral health capabilities. We offer interactive provider scorecards with data on key service and quality metrics and use value-based payment strategies to promote the delivery of high quality care that improves member outcomes.

LTSS positive outcomes

Across our affiliated health plans where we administer LTSS:

We diverted 1,505 members from nursing homes and transitioned 1,186 individuals from nursing facilities to the community in an affiliated health plan.

We have helped 98.6% of our members remain living in the community in one of our plan affiliates.

We increased the percentage of members receiving services in the community from 19% to 40% and reduced the percentage of members in nursing facilities from 81% to 60% in an affiliated plan.

To deliver the solutions that meet members’ needs and preferences, we weave together the right combination of health care, services and supports.