CHCS - Center for Health Care Strategies

Improving the quality and cost-effectiveness of publicly financed health care

Medicaid-Funded Long-Term Supports and Services: Snapshots of Innovation

Gretchen Engquist, PhD, Cyndy Johnson, and William Courtland Johnson, PhD
May 2010
Robert Wood Johnson Foundation and Aetna

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.

* D.A. Shostak and P.A. London, PhD. "State Medicaid Expenditures for Long-Term Care, 2008-2027," America's Health Insurance Plans (September 2008).


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