Nearly five million Medicaid beneficiaries use long-term services and supports (LTSS) accounting for a significant share of total federal and state Medicaid expenditures. State Medicaid programs are pursuing a variety of strategies, including managed LTSS (MLTSS) programs, to shift care delivery from institutional to home- and community-based services, improve the quality of services, and better manage costs. At the same time, Medicaid programs are beginning to explore value-based payment (VBP) arrangements for MLTSS programs that link payment to value vs. volume of services. In most states, emerging VBP strategies are largely built around primary and acute care services, with much less of this activity focused on LTSS.

Through Advancing Value in Medicaid Managed Long-Term Services and Supports, the Center for Health Care Strategies (CHCS) is working with five states — Minnesota, New York, Tennessee, Texas, and Virginia — in a learning collaborative to refine and advance innovative strategies for rewarding value-based LTSS in managed care models. In partnership with West Health Policy Center, this project will advance the adoption of operational strategies to promote high-quality MLTSS programs that support individuals living in their communities. CHCS will share key considerations and emerging strategies to help other states to expand VBP models in their MLTSS programs.


The West Health Policy Center is a nonprofit, nonpartisan resource in wholly funded by philanthropists Gary and Mary West. The West Health Policy Center provides education, expertise, and policy proposals to help seniors successfully age in place, with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life, and independence.