Long-Term Care Frequently Asked Questions
Centauri helps health plans identify Medicaid-eligible members earlier, guide them through the HCBS and LTSS waiver process, and support their care needs in community-based settings — where most members prefer to remain.
Medicaid-eligible members who may qualify for HCBS or LTSS waiver programs in states with managed long-term services and supports. This includes members who may also benefit from Full Dual, Partial Dual, or LIS alignment.
HCBS and LTSS waiver programs support activities of daily living in the community and include coordination of functional eligibility determinations, ongoing care services, and care plan monitoring.
Centauri uses probabilistic predictive analytics to identify members likely to qualify for HCBS or LTSS. Our model delivers 87.4% recall and 26.3% precision, calibrated to each client’s population for accuracy and relevance.
We conduct outreach to educate members about the program and assist with documentation and the application process. Conversations are handled with empathy and respect for personal and medical privacy.
Yes. Centauri coordinates third-party functional eligibility assessments and scheduling so members and plans don’t have to manage the process independently.
Yes. We provide advocacy and reconciliation to ensure members are aligned to the correct aid category and that benefits are represented accurately.
Centauri delivers a 38% conversion ratio, an average capitation differential of $4,500 PMPM+, and supports 1.8 million Medicaid beneficiaries in Managed LTSS programs across 24 states.
Plans receive real-time enrollment and conversion tracking, plus real-time reporting across outreach, submissions, and approvals — providing continuous visibility rather than periodic snapshots.
Yes. The LTC solution is built to scale across state-specific Medicaid waiver programs, accommodating significant variation in HCBS and LTSS eligibility rules.
Centauri operates on a HITRUST r2-certified platform that is independently audited, accredited, and built with a privacy-first approach — especially around documentation and consent.
Medicaid Managed Care Organizations, Medicare Advantage plans, dual-eligible populations, and state Medicaid agencies across 24 states with Managed LTSS programs.
Long-Term Care is one of five Member Connect offerings — alongside Disability Eligibility, Dual Eligibility, Medicaid Retention, and Social Services+ — all designed to help individuals access the benefits and care settings they are entitled to.