Long-term services and supports (LTSS) enable more than 12 million Americans to meet their personal care needs and live with dignity and independence in various community and institutional settings. With Medicaid LTSS costs totaling more than $140 billion annually and the aging population projected to grow 18 percent by 2020, state and federal officials are increasingly seeking ways to improve both the quality and cost-effectiveness of the current system of care. The Center for Health Care Strategies, in partnership with Manatt Health, recently released Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment: A Toolkit for States to help guide states in replicating LTSS reform strategies established in innovator states.

This 60-minute webinar, made possible through support from The SCAN Foundation and the Milbank Memorial Fund, described policy strategies, operational steps, and federal and state authorities that leading states have used to increase access to community-based care and improve integration of LTSS with other Medicaid and Medicare-covered services. It highlighted opportunities and challenges that states faced in pursuing different reforms to help guide policymakers that are seeking to improve care delivery, person-centeredness, and cost-effectiveness of Medicaid LTSS.


I. Introduction and Overview

Speaker: Michelle Herman Soper, Director of Integrated Care, CHCS

Michelle Soper provided an overview of the toolkit for states and described the importance of concrete policy strategies and steps for states to advance Medicaid LTSS reforms.

II. Rebalancing Medicaid LTSS: Matching Care Settings to Individuals’ Needs

Speaker: Stephanie Anthony, Senior Advisor, Manatt Health  

Stephanie Anthony described broad reform strategies and provided examples of innovative states that have used these approaches to rebalance the proportion of LTSS spending for services provided in community settings.

III. State Reactor on Rebalancing LTSS

Speaker: Patti Killingsworth, Assistant Commissioner and Chief of Long-Term Services and Supports, Bureau of TennCare

Patti Killingsworth discussed Tennessee’s rebalancing efforts, including transitioning individuals out of nursing facilities and making targeted investments in LTSS workforce development.

IV. Advancing Integration of LTSS with Physical and Behavioral Health Services through Managed Care

Speaker: Alexandra Kruse, Senior Program Officer, CHCS  

Alexandra Kruse highlighted three innovative reform strategies to better coordinate and integrate LTSS with physical and behavioral health services through managed care by reducing fragmentation and increasing the focus on whole-person outcomes.

V. State Reactor on Integrating LTSS

Speaker: Tammy Whitlock, Director Integrated Care Division, Virginia Department of Medical Assistance Services

Tammy Whitlock described Virginia’s recent efforts to expand a managed model statewide to integrate LTSS with other Medicaid-covered services, as well as Medicare services for some beneficiaries.