Florida’s Statewide Medicaid Managed Care (SMMC) 3.0 program, launched on February 1, 2025, introduces significant enhancements aimed at improving care coordination, integrating behavioral analysis services, and piloting managed care for individuals with intellectual and developmental disabilities.
While MLTSS expands access to home-based care, its success depends on addressing key challenges like workforce shortages, eligibility barriers, care coordination gaps, and transitions from institutional care. Here’s what needs to be done to improve these programs.
Massachusetts and Colorado offer strong MLTSS programs that help Medicaid beneficiaries receive in-home care rather than entering nursing facilities. Their programs provide personal care, home health services, and caregiver support to promote independent living.
Managed Long-Term Services and Supports (MLTSS) help Medicaid enrollees receive in-home care rather than institutional care. These programs focus on independence and quality of life for individuals with long-term care needs.
A detailed exploration of the Making Care Primary Model, an innovative value-based initiative by CMS aimed at transforming primary care.
Wisconsin’s long-tenured Family Care MLTSS Program continues to find success with major goals including increased ability to keep consumers at home, lowered costs and reduced inefficiencies. They continue to raise the bar for national MLTSS programs.
The Tennessee advocates worked with consumers, families, peers, and legislators to create an increase for direct care workers.
Tennessee has built a strong structure for their Medicaid-managed long-term services and supports community with a program they launched in 2010 called CHOICES. Their program has been revered for its flexibility, high quality, and consumer-first approach.
Iowa’s IA Health Link launch left both providers and consumers frustrated by putting their budget before the quality of care. We analyze the missteps they took after setting unrealistic timelines for the work that needed to be done. Their MLTSS program continues to serve as a learning tool for other state’s roll outs.
First up in our review of value-based purchasing in managed care MLTSS programs is Arizona. The program has gone through a variety of upgrades and changes.