States are increasingly implementing Medicaid managed long-term services and supports (MLTSS) programs to accomplish goals including rebalancing spending from institutional care to home- and community-based services, improving beneficiary experience, and better managing costs. But there is relatively limited evidence of the value of these efforts.

This report, originally published in 2017 and updated in 2021, seeks to fill that information gap. Authored by the Center for Health Care Strategies in partnership with the ADvancing States, the report analyzes literature on MLTSS program outcomes as well as responses from states regarding their progress toward attaining MLTSS goals and challenges in collecting data to document progress.

The states’ survey responses reflect overall progress in advancing MLTSS goals. At the same time, their responses highlighted the need for states to expand the data collected on program impacts to build stakeholder support and demonstrate program viability. States also reported lessons related to challenges of better demonstrating program value, including the need for standardized quality measures across MLTSS programs.