Background & Highlights


In FY 2009, older adults and people with disabilities represented 25 percent of all Medicaid beneficiaries but drove 66 percent of total costs ($230 billion out of $346 billion). The aging of the U.S. population is creating increased demand for Medicaid acute and LTSS services, escalating Medicaid costs even as states are facing dwindling resources. To try to bend or flatten the cost curve in Medicaid, the vast majority of states are expanding the use of managed care organizations (MCOs) to deliver Medicaid acute health care and many are incorporating managed LTSS into their Medicaid systems.

MCOs have a long history of success coordinating clinical case and financial risk management aspects of health care for millions of Americans. Similarly, the Aging and Disability Networks have a long history of assisting millions of older adults and people with disabilities by assessing and coordinating their social care needs, as well as effectively delivering quality long-term services and supports, care transitions programs and chronic disease self-care management trainings. Together, MLTSS presents an opportunity for MCOs and the Aging and Disability Networks to build on their complementary expertise to provide quality LTSS.

As a part of the Aging and Disability Partnership for MLTSS, n4a has:

  • Formed a Managed Care Advisory Council (MCAC) comprised of industry leaders from managed care organizations (MCOs), health provider groups, health care service providers and consultants. n4a uses the MCAC to engage with health plans and industry representatives to nurture the dynamic exchange of ideas and further develop relationships. Functioning—through the MCAC—as translators between the health care industry and the community-based agencies, we educate the health care industry on the value of the local A/D Networks and develop tools for CBOs to engage and contract with the health care sector.
  • Provides ongoing business acumen training and technical assistance in the areas of MLTSS and Integrated Care to AAAs, responding to requests from the field and enhancing the Aging and Disability Exchange resource website, including development of a MLTSS Toolkit.
  • Distributes the MLTSS Weekly Update, an online newsletter with updates on Medicaid and Medicaid Managed Care state policy trends specifically selected for the Aging and Disability Networks. Subscribe to the MLTSS Weekly Update.
  • Plays a significant role in the planning and coordination of the ACL Business Acumen Leaning Collaborative in collaboration with the John A. Hartford Foundation, Partners in Care Foundation and ACL. ACL Press Release.
  • Developed, with ACL, the ACL pre-conference on Integrated Care at the n4a Annual Conference; it was entitled Community-based Integrated Care Networks, Taking Next Steps. Materials.