State efforts to improve care for frail elders and adults with chronic needs are increasingly leading them to implement Medicaid managed long-term services and supports (MLTSS) programs. These emerging MLTSS strategies are shaped not only by the state’s internal resources, but also by its experiences in interacting with long-term service and support providers, managed care plans, and beneficiaries.

This brief looks at the paths pursued by Florida, New Jersey, and Virginia in implementing MLTSS approaches focused on helping individuals to live in their communities rather than nursing facilities. Their program design and implementation decisions can be instructive to other states in developing MLTSS programs. The brief also identifies how states’ efforts in MLTSS pave the way for future coordination of Medicare and Medicaid benefits.

This brief is a product of CHCS’ Implementing the Roadmaps: Innovations in Long-Term Supports and Services program. Through this initiative, made possible by The SCAN Foundation, CHCS is helping participating states to rebalance and better manage an array of long-term services and supports for Medicaid populations.