Long-term services and supports (LTSS) enable more than 12 million people to meet their personal care needs and live with dignity and independence in a variety of community and institutional settings. With LTSS expenditures of more than $140 billion annually, Medicaid is the single leading payer of these critical services. The aging population’s projected growth—18 percent by 2020 and doubling by 2060—will only increase demand for LTSS and highlight Medicaid’s unique and important role in providing LTSS. At the same time, these demographics will put more fiscal pressure on Medicaid at both the federal and state levels, prompting states to reform their Medicaid LTSS systems to both improve the quality of care for beneficiaries and contain program costs.

In a new toolkit for states, co-authored with the Center for Health Care Strategies, Inc., and with support from The SCAN Foundation and the Milbank Memorial Fund, Manatt Health provides an overview for state Medicaid officials and other stakeholders interested in understanding or developing state strategies for this increasingly important issue and seeking to identify an appropriate set of evidence-based approaches for their state or community. The toolkit draws on a wellspring of innovations from multiple leading-edge states and LTSS providers that have been working hard to promote LTSS in the community and integrate LTSS with physical, behavioral health and other clinical services. This comprehensive body of knowledge is intended to be a helpful guide toward the goal of advancing high-quality, cost-effective, person-centered care delivery.