Improving the quality and cost-effectiveness of publicly financed health care
Rate Setting for Medicaid Managed Long-Term Supports and Services: Best Practices and Recommendations for States
Medicaid managed long-term supports and services (MLTS) can aid frail beneficiaries living in the community and delay or prevent them from being placed in a nursing facility. Yet while MLTS programs are growing in interest among states, in 2004 only 2% of Medicaid beneficiaries with long-term support and service needs were enrolled in risk-based programs. Developing adequate rate-setting strategies that address the complex needs of the population is one of the challenges for states in designing MLTS programs.
Rate Setting for Medicaid Managed Long-Term Supports and Services: Best Practices and Recommendations for States, coauthored by Richard Kronick, PhD, of the University of California San Diego, and Karen LLanos, MBA, Center for Health Care Strategies, was written to help guide states in developing payment strategies for managed long-term supports and services. The resource paper describes reimbursement models currently being used by state MLTS programs, highlights rate-setting considerations for these programs, and provides suggestions for designing rate-setting approaches that accurately reflect the needs of Medicaid beneficiaries.