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Conflict-Free Case Management

by: 
Linda Nakagawa, MediSked

Everyone is talking about conflict-free case management and states are taking very different approaches to maintain compliance with the national regulations that seek to move away from institutional care and increase the delivery of home and community-based services. This change is frequently accompanied by restructuring of organizations to prevent conflicts of interest.

Conflict-free case management (CFCM) requires that assessment and coordination of services are separate from the delivery of services, with the goal to limit any conscious or unconscious bias a care manager or agency may have, and ultimately promote the individual’s choice and independence. The different regulations surrounding CFCM and conflicts of interest require the restructuring of long term services and supports (LTSS) delivery so that a single agency is not both assessing what services an individual needs and then providing those services to them.

Conflict-free case management and conflict of interest definitions are codified in four federal policy initiatives: The Balancing Incentive Program within The Affordable Care Act (ACA); Community First Choice (CFC) within the ACA; Home and Community-Based Services (HCBS) Settings Final Rule (CMS 2249F) and The Older Americans Act Reauthorization Act.

Check out our solutions brief on conflict-free case management if you’re interested in learning more about how your agency can comply with the requirements.

About MediSked

Founded in 2003, MediSked supports human services organizations across the country, delivering integrated technology solutions and expertise to improve outcomes and cost efficacy in long term services and supports delivery for state and county oversight, payers, care coordination entities, and provider agencies.

Working collaboratively with its clients and partners, MediSked has developed a full-featured software ecosystem, which includes the state-wide data aggregation tools required to support CMS Final Rule transition plans, the capabilities needed to deliver conflict-free case management, and innovations to drive operational efficiencies and improve population outcomes.

MediSked is committed to its mission to be the leading brand in holistic solutions that improve lives, drive efficiencies, and generate innovations for the human services organizations that support our community. MediSked is based in Rochester, New York and maintains offices in Lewiston, New York and Silver Spring, Maryland.