Start: July 2017

Funder: The SCAN Foundation and the Milbank Memorial Fund


Many states are reforming their Medicaid long-term care delivery systems and related programs in the face of rising demand for these services. They are considering how to use Medicaid waiver and demonstration flexibilities to support improvements in care for beneficiaries. New opportunities may encourage more states to craft reforms to their Medicaid long-term services and supports (LTSS) programs, which provide vital supports for older adults and people with disabilities but also drive a signification portion of state Medicaid spending.

In Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment, supported by The SCAN Foundation and the Milbank Memorial Fund, the Center for Health Care Strategies and Manatt Health are working to highlight and expand the use of innovative LTSS reforms. The project seeks to identify successful approaches to: (1) rebalancing LTSS use and spending toward home- and community-based services; and (2) integrating LTSS with physical and behavioral health services. Project activities include:

  • Producing the comprehensive Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment: A Toolkit for States that details state strategies and best practices for strengthening LTSS. Future updates to the Toolkit will be disseminated nationally to states (the primary audience), federal policymakers, and other stakeholders.
  • Facilitating group learning and providing technical assistance to three states, Alabama, Massachusetts, and Ohio as well as the District of Columbia, all of which are pursuing comprehensive LTSS reform strategies to advance the adoption of practices and strategies outlined in the Toolkit. Additional states will be invited to join the collaborative learning component in late 2018.