Forum Session

State Long-Term Care Strategies: Approaches to Managing Care and Controlling Costs
April 25, 2008


Carol V. O'Shaughnessy, MA


For decades, federal and state policymakers have focused on the goals of better managing overall long-term care spending, offering consumers broader access to home and community-based services, and coordinating long-term care services. States have taken different approaches to meet these goals. Approaches range from initiation of managed long-term care programs to consolidation of state long-term care administration and financing in a single state agency. To date, direct state administration is still the dominant way services are financed and delivered, but some believe that state Medicaid managed long-term care arrangements may grow in the future. This Forum session focused on state approaches to managing long-term care. It included an overview of Medicaid managed care and a discussion by state representatives who have redesigned long-term care financing and service delivery, with and without using a capitated managed care approach.


Paul Saucier, Director, Institute for Public Sector Innovation, Muskie School of Public Service, University of Southern Maine; Mary Sowers, Technical Director, Home and Community-Based Services Waivers Program, Disabled and Elderly Health Programs Group, Center for Medicaid and State Operations, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services; Judith Frye, Director, Office of Family Care Expansion, Division of Long-Term Care, Wisconsin Department of Health and Family Services; Pamela Coleman, Deputy Director, Medicaid/CHIP Division, Texas Health and Human Services Commission; Charles E. Reed, Chair, Washington State Home Care Quality Authority

Slides from the presentations by Mr. Saucier, Ms. Sowers, Ms. Frye, Ms. Coleman, and Mr. Reed are available for download.

Related Materials

See also the entries for two related Forum sessions on consumer direction and Money Follows the Person (November 2008) and support of family caregivers (September 2007). A Basic on long-term services and supports is also available.

↑ back to top

Browse Topics Side ArrowDown Arrow