This resource examines Medicaid payment reform strategies for populations who receive LTSS. It includes case studies of state programs in Tennessee, Minnesota, and Arizona.
- A growing number of states are implementing value-based payment programs to deliver LTSS to Medicaid populations with complex needs.
- Payment models include pay-for-performance, supplemental per-member per month payments, shared savings/shared risk, and episode-based payments.
- Measurement strategies for value-based LTSS payment may need to consider less traditional domains such as quality of life, independence, and functional status.
- States can support and direct value-based strategies in various ways, including grants or capacity-building opportunities for LTSS providers.
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Adults Under 65 with Disabilities
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
- What are some promising strategies for states to improve payment models for long term services and support (LTSS)?
- What are some examples of states that have implemented these reforms successfully?
Level of Evidence
PromisingWhat does this mean?