Improving the quality and cost-effectiveness of publicly financed health care
Medicaid Rate-Setting Strategies to Promote Home- and Community-Based Services
States are pursuing a variety of innovative managed long-term services and supports (MLTS) delivery models to improve care for Medicaid beneficiaries. In particular, offering long-term services and supports in home- and community-based settings gives beneficiaries greater freedom of choice and satisfies the preferences of many beneficiaries to live at home. Such programs can provide high quality services more cost effectively for state Medicaid programs. In creating MLTS approaches that foster home and community-based services, states need to explore rate-setting strategies that reward health plans for promoting the use of such services.
To help states better understand the rate setting process in MLTS programs, this policy brief describes rate development strategies that states can use to promote home- and community-based services (HCBS) in MLTS programs, the role of integrated care programs to help expand HCBS, and other considerations for developing rates for MLTS programs.
This policy brief is a product of CHCS' Implementing the Roadmaps: Innovations in Long-Term Supports and Services program, made possible through The SCAN Foundation. Through this program, CHCS is helping participating states to rebalance and better manage an array of long-term services and supports for Medicaid populations.