State Trends in the Delivery of Medicaid Long-Term Services and Supports

Brianna Ensslin
Alexandra Kruse
July 2016

States are increasingly establishing MLTSS programs, which integrate person-centered health care with other support services. This resource, based on interviews with seven states that operate MLTSS programs, identifies six major trends and elaborates on them with examples from the states. The trends are:

  • Increasing Medicare and Medicaid alignment for dually eligible individuals, such as expanding Medicare and Medicaid benefit integration;
  • Broadening enrollment to serve individuals with intellectual and developmental disabilities;         
  • Leveraging housing resources and other social services to keep people in the community;  
  • Focusing on workforce development and expanding scope of practice for clinical and home health professionals (for example, licensed practical nurses, certified homemaker-home health aides, and other assistive personnel);
  • Advancing value-based purchasing with LTSS providers (i.e., paying for quality of outcomes, not volume of services); and
  • Providing ongoing stakeholder engagement by seeking feedback from beneficiaries, advocates, partner agencies, and providers to inform state policymakers on successes and opportunities for improvement.
Posted to The Playbook on
Population Addressed
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
  • What are Medicaid Long-Term Services and Supports (MLTSS) programs?
  • What are the current trends among these programs?
Level of Evidence
Expert Opinion
What does this mean?