Funder: The SCAN Foundation

Author: Brianna Ensslin and Alexandra Kruse, Center for Health Care Strategies

July 2016 | Brief


Medicaid finances 51 percent of the nation’s long-term services and supports (LTSS) costs, making states eager to ensure that they are delivering the highest quality, most appropriate, and cost-effective services possible. As a result, states are increasingly pursuing Medicaid managed long-term services and supports (MLTSS) programs to provide coordinated, person-centered, and cost-effective care.

This brief, developed through support from The SCAN Foundation, outlines current trends in MLTSS innovations and LTSS reforms in seven states—Arizona, California, Kansas, Minnesota, New Jersey, Tennessee, and Texas. It uncovers six major trends:

  • Increasing Medicare and Medicaid alignment for dually eligible individuals;
  • Broadening enrollment to serve individuals with intellectual and developmental disabilities;
  • Leveraging housing resources and other social services to keep people in the community;
  • Focusing on workforce development and expanding scope of practice;
  • Advancing value-based purchasing with LTSS providers; and
  • Providing ongoing, comprehensive stakeholder engagement.

The states examined in this brief are strengthening their Medicaid MLTSS programs to serve more beneficiaries and reduce service fragmentation for Medicare-Medicaid enrollees. Other states can consider the strategies described to develop approaches that can improve care delivery for their own LTSS beneficiaries and providers.