Home & Community-Based Services Eligibility (HCBS/LTSS Eligibility)
Blended rates are a clear incentive for managed care organizations to proactively identify and stabilize members with Home & Community Based Services (HCBS). Finding members that are eligible sooner leads to more resources for the plan to deliver care, avoided unnecessary nursing facility care, and prevented admissions.
Rank-Ordered Lists of Those Eligible for Additional Services (e.g., Nursing Facility Level or ADCMI)
Cyft AI produces highly accurate models featuring:
- All available data including ADLs, free-text notes, and social determinants
- Empirically validated with your data -- not one size fits all
- Tailored to and fully integrated with existing workflows and systems
- Models get better with experience
Progress Reports With Real-Time Feedback
Know the Impact Your Team is Having and Spot Opportunities for Improvement
- Engagement rates compared to baseline
Unable to contact and reasons why
Conversion rates by location and care manager
Overall program performance
Our Clients Typically Plan To:
Outreach to 50 to100 members per month who are most likely to be Nursing Facility Level of Care (NFLOC). In some states, this is known as being Nursing Facility Clinically Eligible (NFCE) or Nursing Home Certified (NHC).
Conduct in-home assessments using instruments such as the MDS or interRAI.
Submit the forms to the state to receive a determination.