Centralized administration


A centralized state LTSS agency or coordinated agencies should: 

  • eliminate unnecessary paperwork and other inefficiencies through administrative and systems reform to help contain costs, 
  • streamline the process for people covered by more than one program, and 
  • have a global budget with authority to allocate funding among an array of LTSS, including both institutional and home- and community-based services. 

The agency or agencies should also: 

  • have fair rate-setting and contracting processes for service providers; 
  • have a structure and process for ensuring quality oversight and outcomes throughout the system; 
  • direct providers to use standard, simple terms and billing forms, including electronic billing; and 
  • make current data on nursing facility charges and all other LTSS providers available to the public.