WHAT IS MLTSS?

Managed long-term services and supports (MLTSS) are long-term services and supports (LTSS) delivered through capitated Medicaid managed care programs. Today, more than half of the states currently provide Medicaid coverage for LTSS through contracts with Medicaid managed care organizations.

 

Children and adults with disabilities and older adults who need support to perform activities of daily living (ADLs) must rely on a variety of services and supports over an extended period, known as long-term services and supports (LTSS). Medicaid provides the only coverage for LTSS other than limited private insurance, with Medicaid paying for 60 percent of the LTSS provided in the United States. States have moved in the last twenty years to provide broad Medicaid coverage through contracts with managed care plans. Increasingly, states are similarly moving non-medical LTSS services for older adults and persons with disabilities away from traditional “fee-for-service” payments to capitated payments under managed care.

 

MLTSS plans understand that these services are very different than those provided by traditional health insurance and have a significant impact on a person’s independence, health, and quality of life. The National MLTSS Health Plan Association brings together the knowledge and experience of integrated health plans, the unique understanding of LTSS and of the variety of persons of all ages with disabilities and functional limitations who need these services, in order to pursue legislative and regulatory changes in Medicare and Medicaid that enable health plans to better serve their members and achieve the appropriate outcomes.