Skip All Navigation

Defining MLTSS

MLTSS refers to a different way of organizing and paying for long term services and supports.  It combines traditional services with managed care approaches.

MLTSS finances, delivers, and oversees LTSS using managed care strategies.

Long term services and supports may include:

Managed care strategies may include:

  • State plan services that all states must offer, such as home health and nursing facility.

  • Optional state plan services, such as personal care, rehabilitation services, targeted case management, and home and community-based services (HCBS).

  • HCBS waiver services offered under Section 1915(c).

  • Additional services offered by the MTLSS contractor "in lieu of" traditional services.

  • Any combination of the above.
  • Contracting with a limited number of organizations for a defined package of services.

  • Holding MLTSS contractors accountable through performance measurement.

  • Using capitation (per person per month payment) to pay the MLTSS contractors delivering service through provider networks established by the MLTSS contractors.

MLTSS is not a single model of care. It's an approach that can be applied in a number of different program models. States have served a variety of population groups, including combining services and funding streams, developing a range of payment methods and using different kinds of MLTSS contractors, as shown in the table below.

click to open MLTSS program examples table
Click to open the table

< Back      Next >