MLTSS

In recognition of a lack of reliable and robust information on the value of state managed long-term services and supports (MLTSS) nationally, this report aims to partially fill the gap with data and evidence from a survey of state agencies and a review of relevant outside research, and to also serve as a jumping off point for future study.

The Center for Health Care Strategies, Inc. released a technical assistance brief, funded through support by the Robert Wood Johnson Foundation, titled "State Medicaid Managed Long-Term Services and Supports Programs: Considerations for Contracting with Medicare Advantage Dual Eligible Special Needs Plans."

On Friday, July1, 2016, Mathematica Policy Research published a report summarizing the basic approach to rate-setting in Medicaid managed care and reviews the main options for structuring managed LTSS (MLTSS) rates. It presents examples from states with financial alignment demonstrations as well as long-standing MLTSS programs. The report concludes by highlighting the policy and operational considerations that should influence a state’s choice of strategy.

Gary Sullivan, a member of UnitedHealthcare in Tennessee, shares his perspective on the benefits he’s received from being a UnitedHealthcare member. Gary, who was a practicing attorney until his retirement, has been wheelchair-bound due to his muscular dystrophy for many years, and has significant need for help with activities of daily living.

UnitedHealthcare Community & State released a White Paper unveiling a proposed quality framework for MLTSS programs. The framework, developed by UnitedHealthcare's National Advisory Board, extends beyond traditional clinical measures to measure the quality of the "services and supports" delivered in MTLSS, which is often most important for those accessing MLTSS benefits.

The Center for Health Care Strategies (CHCS), in partnership with Mathematica Policy Research and Airam Actuarial Consulting, released an issue brief on the state considerations when setting capitation rates for Medicaid Managed Long-Term Services and Supports (MLTSS) programs. CHCS and its partners examined the considerations taken by eight states (Arizona, Kansas, Massachusetts, Minnesota, Tennessee, Texas, Virginia, and Wisconsin) as they established their MLTSS rates.

The AARP Public Policy Institute published a report that examined what state Medicaid agencies need in order to effectively monitor the performance of managed long-term services and supports (MLTSS) programs. Eight states with long-term experience operating and overseeing MLTSS were used to analyze monitoring capacities and develop promising practices. The states were: Arizona, Massachusetts, Minnesota, New Mexico, New York, Tennessee, Texas and Wisconsin.

The University of California San Francisco published a report about dementia care coordination for duals populations with a specific look at the inadequate workforce of dementia-capable care coordinators.Currently, there are twelve states in the process of implementing demonstrations projects. This report examined three-way contracts from seven states that were selected for their expertise in care coordination.

The Integrated Care Resource Center released a brief that offers tips for engaging providers in integrated care programs for Medicare-Medicaid enrollees. Integrated care programs are successful when a broad spectrum of providers are engaged in the process. This brief provides states with tips on how to engage physicians, hospitals, nursing facilities, and community-based service providers that serve Medicare and Medicaid enrollees.