Category: General Evaluations of MLTSS and Integrated Care "Dual Demo" Programs: Key Findings and Implications for Federal and State Policy

Evaluations of MLTSS and Integrated Care "Dual Demo" Programs: Key Findings and Implications for Federal and State Policy

February 28, 2024

The Long Term Care Discussion Group
Wednesday, February 28, 2024, 1:00 to 2:00 p.m.

About half of all states now contract with Medicaid managed care plans to deliver long-term services and supports – managed LTSS or MLTSS programs -- a sizable increase over the last two decades. Ten states, some of which also operate MLTSS programs, participated in the federal Financial Alignment Initiative (FAI) demonstration, which contracted with managed care plans to provide integrated Medicare and Medicaid benefits and coordinated services for dually eligible individuals.

What does the evidence show about the effects of MLTSS and FAI integrated care demonstrations on access, cost, quality and beneficiary experience? In this session, researchers from Mathematica will summarize major findings from recent evaluations of these programs and discuss their implications for federal and state policy.

The session will also discuss what the future may hold. How many more states are likely to switch from Medicaid fee-for-service to managed care to provide LTSS? What are the FAI demonstration states planning to do to promote integrated Medicare and Medicaid LTSS programs after the FAI initiative ends in 2025? What lessons can all states learn from the FAI demonstrations as they further integration of Medicare and Medicaid through other platforms? What are CMS, MACPAC and other federal agencies planning to do to maximize the benefits, and minimize the risks, of these programs to Medicaid and dually eligible beneficiaries?

Debra Lipson, M.H.S.A., is a Senior Fellow at Mathematica. Over her 35 years as a health policy researcher, she has conducted numerous research and evaluations of Medicaid managed care, LTSS initiatives for older adults and people with disabilities, and integrated care for dually eligible individuals. In the last 10 years, she directed several large CMS-funded projects, including one that provided technical assistance to federal and state officials to strengthen their oversight of Medicaid managed care and MLTSS plans, and another that developed and tested two dozen new Medicaid quality measures, including the first set of nationally standardized measures for MLTSS and HCBS.

Danielle Chelminsky, M.P.H, is a Researcher at Mathematica, who directs and plays key roles in several research and technical assistance projects focused on the design and operation of Medicare-Medicaid integration programs for dually eligible individuals.  She currently directs a project for CMS' Medicare-Medicaid Coordination Office that conducts research on beneficiary experiences with FAI demonstration integrated care programs and was deputy director of the Integrated Care Resource Center , which provides technical assistance to states seeking to advance integrated care for dually eligible individuals.

Registrants will have access to the link and dial in information after they register using this link:

Meeting materials will also be posted once available on the Long Term Care Discussion Group website on the PRESENTATION MATERIALS page.

Long Term Care Discussion Group meetings are intended as forums for candid discussion. Dialogue and comments made during these meetings should be treated as off the record.

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