MLTSS Institute

The MLTSS institute is a collaboration between NASUAD members and national Medicaid health plans intended to drive improvements in key MLTSS policy issues, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans.

All three focus areas of the Institute include the common themes of: 1) building state agency capacity; 2) fostering innovation at the state level; and 3) providing a feedback loop to the federal policy dialogue.



NASUAD and CHCS Release Report on MLTSS

The National Association of States United for Aging and Disabilities (NASUAD) is pleased to announce the release of a new report, Demonstrating the Value of Medicaid MLTSS Programs, developed in partnership with the Center for Health Care Strategies (CHCS). The report also marks the first in a series of publications from the MLTSS Institute, which was established in 2016 to drive improvements in key MLTSS policy areas, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans.   

In recognition of a lack of reliable and robust information on the value of state managed long-term services and supports (MLTSS) nationally, the report aims to partially fill the gap with data and evidence from a survey of state agencies and a review of relevant outside research, and to also serve as a jumping off point for future study. 

States identified the following issues as important outcomes to pursue when implementing an MLTSS program and to measure when demonstrating its value:

  • Rebalancing Medicaid LTSS spending from institutional care to home and community based services; 
  • Improving member experience, quality of life, and health outcomes; 
  • Reducing waiting lists for waiver services and increasing access; and 
  • Increasing budget predictability and managing costs. 

NASUAD hopes that this report will generate a national dialogue on the value of MLTSS programs, stimulate thoughtful policy development and program design, and promote high performing state systems that provide care for older adults and persons with disabilities. 

Click here to view the report. 

Direct State Technical Assistance

As part of the MLTSS Institute, NASUAD and consultants on retainer, as needed and appropriate, will provide intensive, state-specific technical assistance on a wide range of MLTSS issues.These may include:

  • Presentations to state leadership, legislators and providers on national MLTSS trends and implications for state on implementation and oversight
  • Serve as a national subject matter expert in meetings with key advisory boards and taskforces in the community to chart short and long term planning objectives. 
  • Reviewing and providing feedback on quality strategies/measures
  • Writing or editing state‚Äôs managed care authority documents (SPAs or waivers); MLTSS RFPs or managed care contracts
  • Development and/or review of MCO readiness review tool and recommendations for addressing MLTSS program elements, including participation on readiness reviews if requested

MLTSS Policy Academy

The policy academy will bring together selected national thought leaders on a variety of MLTSS topics to identify practices or activities that have shown demonstrable impact. For example, it has been documented[1]  that strong state oversight of MLTSS contracts is key to successful programs; however, state resources are limited.  The policy academy would articulate alternative approaches to rigorous oversight and contractor management, leading to white papers or issue briefs documenting those findings.  Other topics might include network adequacy, employment supports, housing, social determinants of health, and pay-for-performance.

State and Health Plan Collaboratives

NASUAD will sponsor semi-annual in-person roundtables. Each roundtable or collaborative will focus on 2-3 topics of interest from a variety of perspectives.  NASUAD will bring in national experts as well as Federal policy officials, where appropriate, to spur lively and fruitful exchange of information and problem-solving.   

Click here to view the MLTSS Map.

MLTSS Institute Advisory Board Members: 

Name  Organization Title 
Sharon Alexander Amerihealth Caritas Vice President, MLTSS
Catherine Anderson UnitedHealthcare Senior Vice President, Policy & Strategy 
Michelle Bentzien-Purrington Molina Healthcare, Inc. Vice President, MLTSS and Duals Integration
Curtis Cunningham  Wisconsin Department of Human Services  Assistant Administrator, Long Term Care Benefits and Programs 
Merrill Friedman  Anthem, Inc.  Sr. Director, Disability Policy Engagement 
Diane Gerrits Wellcare, Inc. Senior Director, Medicaid Policy
Katherine Layman Texas Health and Human Services Commission Senior Policy Director
Patti Killingsworth  Tennessee Bureau of Tenncare  Chief, Long Term Services and Supports 
Eunice Medina Florida Agency for Health Care Administration  Chief, Bureau of Plan Management Operations
Michael Monson Centene, Inc.  Vice President, Long Term Care & Dual Eligibles 
Ginny Rountree  Arizona Health Care Cost Containment System Administration Assistant Director, Operations & Clinical