How States Structure MLTSS Programs Differently and Why It Matters
LTSS programs can look very different from state to state. Learn how design choices shape access, coordination, accountability, and the consumer experience.
LTSS programs can look very different from state to state. Learn how design choices shape access, coordination, accountability, and the consumer experience.
MLTSS programs are designed for different populations across states, from older adults and people with physical disabilities to dual-eligible members and individuals with I/DD or behavioral health needs.
New York lawmakers are considering a Medicaid behavioral health carve-out that would return services to a fee-for-service model.
MLTSS is one of the most consequential design choices in Medicaid. This overview explains where it came from, what it covers, why it matters, and how value-based payment is increasingly shaping MLTSS contracts.
Florida’s ICMC Medicaid program for individuals with IDD expanded statewide in 2025, leading to a membership increase for Florida Community Care. Learn more about the program’s impact.
Medicare Shared Savings Program ACOs saved the program $4.1 to $8.1 billion between 2012 and 2019, with smaller physician-led organizations showing the most impact.
Idaho plans to shift all Medicaid services to private managed care by 2029, with health officials cautioning the transition must be gradual to avoid disruption.
Florida’s SMMC 3.0 program places a strong emphasis on value-based purchasing, rewarding providers for quality and cost-effective care. This shift is central to improving outcomes and ensuring Medicaid recipients receive better, more coordinated services.
Category: Healthcare Payers
Illinois has awarded $12 billion in contracts to four health plans as it transitions to a fully integrated D-SNP model for dual-eligible beneficiaries beginning in 2026.
Florida’s Medicaid program has introduced a pilot initiative transitioning waiver services for individuals with intellectual and developmental disabilities to managed care in two regions.