MLTSS

Prior to COVID-19, Indiana hosted stakeholder workgroups to identify needed improvements to its Medicaid-funded long-term services and supports (LTSS) system. The pandemic amplified existing disparities, including inequitable access to community-based care, unaligned and uncoordinated care for dually eligible individuals, and broad gaps in capacity and resources to effectively oversee and implement the LTSS reform effort. With support from Arnold Ventures, Indiana’s Family and Social Services Administration (IN FSSA) is working with project partners to design a Medicare-Medicaid integration strategy for dually eligible individuals enrolled in MLTSS and engage providers in its development process.

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 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 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.

CMS recently released a 2017 update to its 2012 MLTSS inventory, compiled by Truven Health Analytics. This study reviewed available information about the status of Medicaid MLTSS programs, and provides updates on the prevalence of MLTSS programs, total enrollment, and specific program design elements as of August 2017. The report surveys the landscape of MLTSS programs across the country, provides detailed summaries of each MLTSS program, and identifies national trends.

Presentation from the 2017 HCBS Conference on the "Framework for LTSS Quality in Pennsylvania and Virginia".

Presentation from the 2017 HCBS Conference on "Compliance Isn’t Quality: Building an Authentic Quality Framework in Managed Long-Term Services and Supports Programs".

This toolkit module provides information and tools to help community-based organization (CBO) leaders assess their agency’s readiness to offer vended services to managed care organizations (MCOs), hospitals, and other payers.

In 2017, ADvancing States administered a survey of state agencies that deliver LTSS, including aging and disability agencies as well as Medicaid programs, regarding the significant policy, fiscal, and operational issues occurring within each state. During the survey, we collected detailed information about the structure of agencies, the supports provided, and the populations served by state programs.

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."