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Managed Long-Term Services and Supports: Status of State Adoption and Areas of Program Evolution

Chapter 3 offers a status report on state adoption of managed long-term services and supports (MLTSS). State Medicaid programs increasingly use managed care as one of several strategies to improve care coordination and manage spending for populations with complex health care needs and disproportionately high Medicaid expenditures. As states gain experience with MLTSS, attention is turning to program outcomes. While there is modest evidence of some successes, lack of baseline data to track experiences prior to the implementation of MLTSS and lack of appropriate standardized quality measures have limited the ability to compare states’ experiences and outcomes.

Chapter 3 describes what is known about program outcomes, the complexity that long-term services and supports add to the operation of Medicaid managed care, and highlights emerging trends in MLTSS, such as the increasing enrollment of people with intellectual or developmental disabilities. The chapter concludes by identifying issues that the Commission will explore and monitor as its deliberations on MLTSS continue.

From: June 2018 Report to Congress on Medicaid and CHIP