Leap of Faith: Managed Care and the Privatization of Medicaid Long-Term Care Services

Abstract

Following the passage of the Affordable Care Act, with its expansion of Medicaid in those states willing to embrace it, insurance companies became more interested in the Medicaid market.

That interest has extended into administering what are called Managed Long-Term Services and Supports (MLTSS). And yet too often, when it comes to turning over their Medicaid long-term care funding to insurers, states seem to operate on faith, not facts. This article examines some of the facts concerning MLTSS, and finds that "[w]hile MLTSS success has not been clearly established, its problems are manifest, and its failure, given the vulnerability of those receiving services, can be measured in human lives."

Keywords: Insurance, MLTSS, long-term care, nursing homes, aging, managed care

JEL Classification: I11, I18