This study examines the specific capacities that state Medicaid agencies need to monitor the performance of managed LTSS (MLTSS) programs. It sought to identify promising practices in state oversight as well as the monitoring capacities that should be in place when states begin to implement new or expanded MLTSS programs. Lessons were drawn from oversight practices in eight states (AZ, MA, MN, NM, NY, TN, TX, WI) that have many years of experience operating and overseeing MLTSS.
This report provides a summary of how long-term services and supports (LTSS) are financed and describes factors that contribute to uncertainty of the future costs for LTSS, including changes in how LTSS will be delivered. Three projections of future LTSS spending for senior populations under different scenarios are offered. These scenarios differ based on projecting the number of people with varying functional limitations and the resulting need for varying degrees of LTSS.