WellSky® and NASDDDS Survey Reveals States Anticipate Challenges in Complying With New Federal Requirements for Home- and Community-Based Services

Majority of respondents believe they will need new technologies and additional guidance from the Centers for Medicare & Medicaid Services

WellSky, a leading health and community care technology and services company, and the National Association of State Directors of Developmental Disabilities Services (NASDDDS), today shared the results of a survey assessing the readiness of states to comply with the Ensuring Access to Medicaid Services final rule (Access Rule) issued by the Centers for Medicare & Medicaid Services (CMS).

The Access Rule aims to improve access to home- and community-based services for Medicaid beneficiaries. However, it also presents challenges to state agencies and providers who must implement these changes. Those challenges include:

• The need for new technology. More than 50% of respondents reported that each of the rule’s provisions around quality measures, reporting wage pass-through to direct care workers, managing critical incidents, and accepting grievances from beneficiaries would require them to build, change, or enhance their data systems.
  
  
  
  
• Lack of data-sharing. Another provision of the rule requires states to incorporate data sources such as claims, Medicaid Fraud Control Unit data, and data from agencies such as adult protective services (APS) to identify critical incidents that are unreported by providers. However more than 80% of respondents rated their data-sharing capabilities with APS as “fair” or “poor.” Nearly 80% reported that lack of interagency cooperation or incompatibility of interagency data is a challenge.
  
  
  
  
• Questions about direct care reimbursement. The rule also requires 80% of Medicaid reimbursements be paid to the direct care workers providing the services. Respondents found this requirement needs the most sub-regulatory guidance from CMS, will require new technology, and that current provider compensation data is not sufficient to ensure compliance.

“The Access Rule will present an unprecedented need for state and federal collaboration,” said Mary P. Sowers, executive director of NASDDDS. “NASDDDS and our partners, including our sister associations, are poised to elevate our members’ voices as key sub-regulatory guidance is developed.”

A total of 46 directors and staff at state developmental disabilities programs across the country participated in the NASDDDS Industry Survey on the Access Rule. WellSky initiated and sponsored the survey to determine how best to help state agencies comply with the rule.

“This survey indicates just how challenging the Access Rule will be for our state clients,” said Bill Miller, CEO of WellSky. “We look forward to helping our clients achieve the goals of the rule — greater access to high quality care, improved safety of individuals in the program, and improved quality of life for our communities.”

To learn more about what state disabilities directors had to say, you can download the complete survey.

About WellSky^®

WellSky is one of America’s largest and most innovative healthcare technology companies leading the movement for intelligent, coordinated care. Our proven software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations scale processes, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care. WellSky serves more than 20,000 client sites — including the largest hospital systems, blood banks, cell therapy labs, home health and hospice franchises, post-acute providers, government agencies, and human services organizations. Informed by more than 40 years of providing software and expertise, WellSky anticipates clients’ needs and innovates relentlessly to build healthy, thriving communities. For more information, visit wellsky.com.

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