CareStar has been a certified Case Management provider for the Aged and Disabled (A&D) and Traumatic Brain Injury (TBI) Waivers for the State of Indiana since 2006. The A&D/TBI Waiver allows individuals who are aged, blind, or disabled, or who have a traumatic brain injury to remain in their home as an alternative to nursing facility placement. Home and community-based services (HCBS) are provided through the Waiver to supplement informal supports for people who would require care in a nursing facility if community-based or other supports were not available. CareStar Case Managers conduct assessments to ensure person-centered supports are identified that address the health and wellness of the individuals served. Ongoing monitoring of paid services and informal supports allow for needs to be addressed and service plans to be updated. CareStar Case Managers build meaningful relationships with individuals that promote effective communication and promote the dignity of the individual.
Populations Served: CareStar provides services to individuals on the A&D/TBI Waivers who are aged, blind, disabled or have a traumatic brain injury, who without these waiver services would require care in a nursing facility.
Location: CareStar is a Statewide provider in the A&D Program.
Application Process: Application for services can be made by contacting a local Area Agency on Aging (AAA) or individuals can apply for services at their local Bureau of Developmental Disabilities. Also, for additional information, visit the Division of Aging or Division of Developmental Disabilities website.
In 2013, CareStar became certified to provide waiver case management services to individuals with Intellectual/Developmental Disabilities diagnoses. The Community Integration and Habilitation (CIH) and Family Support Waivers (FSW) enable individuals to remain in their homes or community-based settings and assist individuals who are transitioning from State-operated facilities or other institutions into community settings. Home and Community-Based Services (HCBS) waivers allow flexibility in providing the supports necessary to help individuals gain and maintain optimum levels of self-determination and community integration. CareStar uses Person-Centered Planning as a method of discovery of gifts and capacities, preferences, supports needed, and a vision for the individuals future. Case Managers work to create partnerships with the individual and those important to that individual, waiver providers and community resources. These partnerships make for a stronger circle of support.
Populations Served: In the CIH and FSW Programs, CareStar serves individuals with an intellectual or developmental disability, autism spectrum disorder or related conditions who have substantial functional limitations.
Location: CareStar is a Statewide provider in Indiana for this Program.
Application Process: To apply for services, individuals should obtain the number of the local Bureau of Developmental Disabilities Services (BDDS) office by calling (800) 545-7763. A BDDS staff member will provide an application for waiver services, as well as next steps. Once the individual has been approved for the waiver, there will be an opportunity to choose a Case Management provider. When CareStar has been chosen as the Case Management provider, a CareStar Case Manager will reach out to the applicant within 48 hours of being provided the information by BDDS, to begin building a partnership with the applicant.
Population Health – Health Risk Assessments (HRA)
CareStar has partnered with Managed Care Plans to complete telephonic and in-person Health Risk Assessments, Health Needs Assessments and care planning for eligible members. CareStar completes the assessments to gather updated health history and to determine if there are any identified health or social service needs. Risks identified for the individual during the assessment are reported for additional care management follow-up. CareStar is committed to helping identify an individual’s needs and providing resources when necessary.
Population Served: Members of a managed care plan or other medical insurance provider.
Location: CareStar can perform these services where members reside or telephonically.
Multiple Sclerosis Society Case Management
Since 2016, CareStar has partnered with the National Multiple Sclerosis Society to provide Case Management and Assessment services to eligible individuals. The goal of the partnership is to help individuals living with and managing their Multiple Sclerosis, set goals for and receive appropriate care, support, and safety to improve their independence and quality of life. For each individual, CareStar will perform an initial assessment, develop a person-centered care plan, link the individual with caregivers and resources, and follow-up to ensure the plan is being executed and accomplished.
Populations Served: CareStar serves individuals of all ages, who have been diagnosed with Multiple Sclerosis and who the MS Society’s Case Management Program deem eligible.
Location: CareStar can perform services, both telephonically and in-person, across the United States.
Application Process: If you, or a family member, has been diagnosed with MS and believe could benefit from CareStar’s Case Management services, please contact an MS Navigator by calling 1-800-344-4867 and request to work with CareStar. If the Case Management Program eligibility and criteria has been met, the MS Society will refer the applicant to an authorized Case Management Agency (CMA). The CMA will contact the applicant to schedule and complete the assessment, develop goals, and develop a person-centered care plan.
Quality and Utilization Review
CareStar is proud to be Quality Improvement Organization-like (QIO-like) certified by the Centers for Medicare and Medicaid Services (CMS). As a leader in Case Management, Assessment, Technology and Software Development, CareStar uses this Certification to assist our customers with quality assurance, improved healthcare outcomes and reduced costs. Additionally, CareStar engages physicians in specialty areas including, but not limited to, Family Medicine, Cardiology, Pulmonology, Gastroenterology, Neurology, Vascular Surgery, Internal Medicine, and Cardiovascular and Thoracic Surgery, to expand our expertise and capabilities and ensure efficiency and accuracy of our QIO-like activities.
Administered by CMS, a QIO-like Organization is made up of a group of expert healthcare clinicians and professionals contracted to complete utilization reviews and analyze patterns of care related to medical necessity and quality review. State Medicaid Agencies and organizations contracting with CareStar for QIO-like services are eligible for an enhanced Federal match of funds up to 75 percent. The QIO-like Certification is one of CMS’s most significant programs to improve quality and efficiency of healthcare delivery. . As of March 2020, CareStar is one of 76 organizations to hold this certification nationally