Capitol Correspondence - 04.09.18

Updated CMS Report on Medicaid MLTSS

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The Center for Medicare and Medicaid Services (CMS) recently released an updated report on the status of Medicaid Managed Long Term Supports and Services (MLTSS). Compiled by Truven Health Analytics, the report offers updated numbers on the amount of Medicaid MLTSS programs and total enrollment, as well as updated information on program design elements. The report documents rapid growth of Medicaid MLTSS. Click here for the full report, and see below for key findings as listed on pages 3-4 of the report.


  • Twenty-four states operated MLTSS programs in 2017, a 50 percent increase from the 16 states with these programs in 2012.
  • More states offered multiple programs, with 11 states offering more than one MLTSS program; several of these states established separate programs for people dually eligible for Medicare and Medicaid as part of the CMS Financial Alignment Initiative.
  • The total number of MLTSS programs more than doubled from 19 programs in 2012 to 41 programs in 2017.
  • Total enrollment in MLTSS programs more than doubled, from 800,000 in 2012 to 1.8 million in 2017.
  • More states used §1115(a) demonstrations to authorize the managed care portion of MLTSS programs in 2017 (19 programs; 46 percent of programs) than in 2012 (five programs; 26 percent).
  • As in 2012, a slight majority of 2017 programs required mandatory enrollment for participants (21), while 20 programs had voluntary enrollment.
  • The most common populations served continued to be older adults (33 programs in 2017) and adults with physical disabilities (30 programs in2017).