The QuiLTSS Reconsideration Committee’s obligation is to review any grievance filed by a facility/company and come to a consensus on the validity of their grievance. Once a decision is determined, the committee reports its decision to TennCare’s Value Based Purchasing team to document results and make the appropriate changes for appropriate scoring and payment.
Quality Improvement in Long-Term Services and Supports or QuILTSS is a TennCare value-based purchasing initiative to promote the delivery of high quality Long-Term Services and Supports (LTSS), focusing on the performance measures that are most important to people who receive LTSS and their families. The program will reward providers that improve the member’s experience of care and promote a person centered care delivery model. The QuILTSS initiative includes outcome based reimbursement for services such as Nursing Facility Care, Enhanced Respiratory Care, Home and Community Based Services, Behavioral Health Crisis Prevention Intervention and Stabilization Services (SOS), as well as a program dedicated to the development of the LTSS workforce.