Medicaid costs continue to climb nationwide, taking up an increasing percentage of state budgets. Long-Term Services and Supports (LTSS) costs represent almost one-third of all Medicaid spending, and service delivery is often disconnected and financially misaligned. Compelled to action by tighter budgets, state leaders are increasingly looking to managed care  systems in order to control costs.

Alvarez & Marsal (A&M) has prepared this primer to serve as a guide to help inform states’ decision making processes supporting transformation into a managed LTSS system. The following sections discuss three managed care models, their respective structures, the advantages and challenges of each, as well as additional considerations for states, including enrollment, financial management and procurement.

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