States seeking ways to rebalance their system of long-term services and supports (LTSS) away from institutionally-based care and toward home- and community-based services should consider participation in the Balancing Incentive Program. This program offers states enhanced federal financing to fund non-institutionally based LTSS within their Medicaid programs. To receive these funds, states must include the following core elements in their LTSS programs: (1) a “no wrong door/single entry point” system; (2) conflict-free case management; and (3) a core standardized assessment instrument.

To help states better understand the Balancing Incentive Program, this technical assistance brief describes the core structural elements in detail and provides an overview of state considerations and potential approaches to meeting these requirements.

This technical assistance brief was part of CHCS’ Implementing the Roadmaps: Innovations in Long-Term Supports and Services program, which was supported by a grant from The SCAN Foundation. Through this program, CHCS helped participating states to rebalance and better manage an array of LTSS for Medicaid populations.