“Managed Long-Term Services and Supports (MLTSS)” means that LTSS (typically including both home and community-based services (HCBS) and institutional-based services) are delivered through capitated Medicaid managed care programs. Instead of charging a fee for each service, managed care organizations (MCO) receive a capitated daily or monthly rate from the state for each participant. An individualized service plan is then developed for each LTSS participant based on assessed needs and desired outcomes. MCOs negotiate with their network of providers to develop rates for services they deliver. States often adopt MLTSS in hopes of lowering state LTSS
Medicaid costs, serving more people, and decreasing reliance on costly residential facilities. However, participants and advocates also say it can lead to less individualized choice and reductions in quality.