Over the next two decades, analysts project that states will collectively spend nearly $1.6 trillion dollars for long-term care supports and services (LTSS) for elderly and disabled citizens and the federal government will contribute an additional $2.1 trillion, for a total of $3.7 trillion. Current estimates are that more than two-thirds of Americans age 65+ today will need long-term care with an average duration of need of about three years.* In response, states are seeking fresh approaches for delivering Medicaid-funded LTSS, with an emphasis on reducing costly institutional care through home- and community-based (HCBS) “aging in place” initiatives.

This report presents an array of innovative initiatives from across the nation offering alternatives for reforming the delivery of Medicaid-funded long-term care. It includes both innovations that have been implemented as well as promising practices for more effectively delivering community-based long-term supports and services. Innovations included cover:

• Provider-focused initiatives;
• New directions for managed long-term care;
• Administrative and financing solutions; and
• Emerging telehealth technologies.

Innovations in the Medicaid Continuum of Care Series

This report is part of CHCS’ Innovations in the Medicaid Continuum of Care series, developed to help state and federal policymakers identify high-quality and cost-effective strategies for addressing the full range of clinical and long-term supports and services (LTSS) needs of Medicaid beneficiaries.