The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care.

The Affordable Care Act (ACA) provides incentives for states to implement certain policies and practices that have proven effective at promoting access to long-term services and supports in the community. States’ experience has shown that operational details can have a significant impact on whether plans to provide more services and supports in the community succeed.

This brief highlights two important aspects of operations in state Medicaid programs that affect access to long-term services and supports in the community: efforts to provide accurate and timely information to consumers, and procedures to make Medicaid eligibility determinations quickly and efficiently.

Issue Brief (.pdf)