States and the federal government are moving rapidly towards MLTSS-a broad
set of initiatives aimed at expanding managed health care to include personal
assistance and other services for the frail elderly and younger people with
disabilities. In many models, fee-for-service reimbursement would be replaced by
capitated, risk-based arrangements where managed care organizations (MCOs) and
their health and long-term care partners work together to control costs and
improve outcomes through fully integrated care.
Currently, most MLTSS initiatives are focused on the Medicaid population,
particularly those dually eligible for both Medicare and Medicaid. Fully
integrated care has great, but largely unproved, potential.
The Catholic Health Association of the United States commissioned this paper,
authored by Howard Gleckman of the Urban Institute, to explore, for our
eldercare members and others, the scope of current managed long-term supports
and services (MLTSS) initiatives, their potential impact on patients and
providers and the opportunities and challenges they present. Made available in
February of 2014, this 24-page article, which includes two case studies, is
available hardcopy or for electronic download.