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 worked to highlight and expand the use of innovative LTSS reforms. The project sought 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 included: