MLTSS

This brief draws from interviews with states operating new and long-standing MLTSS programs to identify six major trends in the refinement of MLTSS and underlying LTSS delivery systems nationally. The states examined in this brief are strengthening their Medicaid MLTSS programs to serve more LTSS beneficiaries and facilitate the development of integrated care programs that reduce service fragmentation for Medicare-Medicaid enrollees, particularly through Medicare Advantage D-SNPs

This issue brief discusses state policy trends using data from KFF’s 18th annual 50-state survey. It discusses policy areas such as implementation of electronic visit verification and value based payment models. The brief highlights key findings across the topics areas of HCBS program flexibility, MLTSS, and response to federal regulations

This report is the third in a series of publications from the MLTSS Institute. The report identifies the challenges and promising practices in addressing the mismatch between supply and demand for direct care workers in long term services and supports programs, all viewed through the lens of MLTSS programs. This report is co-authored by ADvancing States and Sage Squirrel Consulting, LLC.

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide presents a checklist of four issues for consideration as states identify issues to consider when developing and adopting value-based payment (VBP) models for HCBS within managed long-term services and supports (MLTSS) programs. The guide also reviews strategies for stakeholder engagement.

This study from Milliman highlights the success that MLTSS programs have had in reducing institutional care for older adults and people with disabilities compared to states operating a fee for service system, both in absolute numbers as well as the acuity level of consumers receiving services in nursing facilities.

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide outlines considerations for adopting value-based payment (VBP) to promote high-quality MLTSS programs. It combines insights from five states - Minnesota, New York, Tennessee, Texas, and Virginia - with input from national health policy experts.

This chapter is part of MACPAC's June 2018 Report to Congress on Medicaid and CHIP. It reports on the trend of states using managed long-term services and supports (MLTSS). The chapter discusses program outcomes, the added complexity of long-term services and supports in Medicaid managed care, and different directions being explored in MLTSS. It also identifies issues for further examination.

This paper examines whether there is evidence that MLTSS programs increase access to home and community-based services (HCBS). One theory states that MLTSS programs may reduce costs associated with the use of institutional services, thereby allowing states to expand HCBS services and reduce waiting lists. This brief uses this theory and examines changes in a state's HCBS waiting list as one way to measure access to HCBS.

This paper explores how state MLTSS programs interact with federal LTSS initiatives. It examines this interaction in four states: Illinois, Iowa, New York, and Ohio. It specifically focuses on the the interaction of these states' MLTSS programs with the Money Follows the Person (MFP) demonstration, the Balancing Incentive Program, the Health Home State Plan Option, and the Financial Alignment Initiative (FAI).

This paper looks at the impact of various MLTSS policies on access to LTSS. It looks specifically at four states and the policies which these states identify as important to ensuring access. All four states identified network adequacy standards, transition of care, provider reimbursement, and level of care criteria as important factors. In addition, the paper examined participant-directed services policies and care coordination models.