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How Community-Based Organizations Contract and Receive Reimbursement for Home and Community-Based Services in Medicaid Arrangements – A Blueprint for Success

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Logo of the consulting group, Health Management Associates, with the tagline, "No one knows health care like we do"

Community-based organizations (CBOs) have a long history of supporting people with disabilities and older adults to live and thrive in the community, through a variety of funding structures. States are increasingly realizing the value of these organizations as providers and partners in their Medicaid-funded programs. At the same time, many states are partnering with Medicaid managed care organizations to provide long-term services and supports (LTSS) and considering value-based payment structures for LTSS. This creates both opportunities and challenges for CBOs who have had experience serving individuals who need assistance to be able to live independently in their own homes.

During this webinar, presented by Health Management Associates, a panel of experts will provide real-world strategies that CBOs can use to effectively expand access to their services, work with state Medicaid programs, contract with managed care, and ensure sufficient reimbursements.


Julie Hamos, Principal, Health Management Associates, Chicago
Marisa Scala-Foley, Director, Office of Integrated Care Innovations, Administration for Community Living, U.S. Department of Health and Human Services
Mary Kaschak, Deputy Director, Aging and Disability Business Institute, National Association of Area Agencies on Aging
Erica Anderson, Senior Director, National Association of States United for Aging and Disabilities

Learning Objectives

  1. Learn where CBOs fit within Medicaid-funded long-term services and supports, in an increasingly value-based and integrated healthcare landscape.
  2. Understand the challenges in moving from grant-based funding to payment structures based on the development of networks, utilization management, and quality.
  3. Identify various contracting strategies available to CBOs in dealing with Medicaid managed care health plans.
  4. Obtain case studies of successful CBO approaches to contracting and reimbursement, including tips on how to form networks of community-based providers.
  5. Learn how to address back-office functions, reporting requirements, and IT challenges that come with managed care contracting arrangements or participation in a CBO network.

Who Should Attend

Representatives of community-based organizations, providers serving older adults and individuals with disabilities, state policy officials, managed care organizations interested in working with CBOs, providers and administrators involved in continuity of care initiatives.