Forum Session

Medicaid Managed Long-Term Services and Supports (MMLTSS): Lessons from Three States
October 5, 2012


Carol V. O'Shaughnessy, MA


In recent years, more states have begun implementing Medicaid managed long-term services and supports (MMLTSS), garnering attention from national organizations and consumer advocacy groups that promote quality LTSS for people with functional limitations. A recent report for the Centers for Medicare & Medicaid Services (CMS) indicates that 26 states will have MMLTSS programs by 2014, up from 8 states in 2004 and from 16 states in 2012. In the second of two meetings on MMLTSS, this Forum session explored issues in planning and implementing programs and discussed the experiences of three state Medicaid agencies. Arizona, a veteran of MMLTSS, began its Arizona Long-Term Care System (ALTCS) in 1988. ALTCS operates on a statewide basis and enrolls about 52,000 people. Star+Plus in Texas began in 1998 and operates in part of the state. Texas has about 401,000 people enrolled and is expanding its program to other regions of the state. Delaware, a newcomer to the field, began implementation of Delaware Diamond State Health Plan-Plus (DSHP-Plus) in April 2012. The program is statewide and has 4,800 people enrolled. Key program designs, oversight of network and beneficiary choices, and lessons learned regarding state budgets and cost savings were among the issues addressed.


Sarah Barth, JD (bio)
Senior Program Officer
Center for Health Care Strategies

Thomas J. Betlach (bio)
Arizona Health Care Cost Containment System (AHCCCS)

Erica Stick (bio)
Special Advisor
Office of the Executive Commissioner
Texas Health and Human Services Commission

Rosanne Mahaney (bio)
Division of Medicaid & Medical Assistance
Delaware Health and Social Services

Related Materials

Another Forum meeting on MMLTSS, "Medicaid Managed Long-Term Services and Supports (MMLTSS): Increasing State Interest and Implications for Consumers, Quality of Care, Providers, and Costs," was held in May 2012.

See also Paul Saucier et al., “The Growth of Managed Long-Term Services and Supports (MLTSS) Programs: A 2012 Update,” prepared for the Centers for Medicare & Medicaid Services (CMS) by Truven Health Analytics, July 2012.

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