“In the wake of findings detailed in a new report from the Government Accountability Office made public on Wednesday, the Centers for Medicare & Medicaid Services will take steps to ensure that states have sufficient incentives to use the billions of dollars they receive for the provision of Medicaid managed long-term services and supports.  If their payment structures are designed properly, MLTSS programs can enable states to expand community-based care and lower associated costs, the GAO said. CMS, however, does not consistently require states to report on whether those payment structures — payment rates, incentive payments and penalties — are achieving program goals, the GAO found.”

LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):
States want the MLTSS money, but don’t want to prove it is cost-effective. Why? Because it isn’t. Rebalancing from institutional to home care, desirable as it may be, does not save money. The only way to fund a full continuum of care is to reduce dependency on Medicaid and attract more private financing from stronger spend down rules, home equity conversion and private LTCI.

GAO recommends increased CMS oversight of Medicaid LTSS payment rates

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