Press Release: Arizona for Better Medicaid Releases MLTSS Research

New Research from Arizona for Better Medicaid Demonstrates Value of Managed Care Model for Long-Term Services and Supports

(Phoenix, Ariz. July 13th, 2021) – Arizona for Better Medicaid, a statewide coalition committed to building a better Medicaid system in Arizona, today released two reports prepared by Health Management Associates (HMA) demonstrating the benefits of integrating Long-Term Services and Supports (LTSS) into managed care programs, including for those with intellectual or developmental disabilities (I/DD).

LTSS refers to a broad range of health and health-related services and supports needed by individuals with challenges for self-care due to a physical, cognitive, or mental condition. LTSS services can improve a members’ quality of life and help people live more independently by assisting with personal and health care needs and activities of daily living such as attendant care, physical and occupational therapies and day treatment programs. While most benefits in Arizona are currently organized in a Managed Care system, benefits for I/DD individuals are largely still managed by the state.

“Demand for Long-Term Services and Supports is growing across the country and in Arizona. The research gathered by the Health Management Associates (HMA) demonstrates that the Managed Care model provides better coordinated care that focuses on better outcomes for individuals,” said Arizona for Better Medicaid Executive Director Bettina Nava.“In Medicaid programs across the country, fully integrated LTSS programs have proven to better serve some of society’s most vulnerable, particularly those with intellectual or developmental disabilities.”

The two HMA reports – “Growth in MLTSS and Impacts on Community-Base Care” and “Managed LTSS Improves Quality of Care” – gather data from state Medicaid programs across the country, providing clear evidence that integrated LTSS expands access to quality care, improves the health care experience, strengthens beneficiary health and well-being, and increases cost predictability.

The reports detail the growing demand for quality LTSS and how managed LTSS programs can improve access, experience, and outcomes:

  • More than 50% of adults aged 65 and older are projected to develop significant disabilities and require LTSS.
  • The number of Americans with I/DD is estimated to be as high as 6.2 million, with significant rates of LTSS utilization.
  • The number of integrated LTSS programs serving adults with I/DD grew from eight states and nine programs in 2012 to 18 states and 25 programs in 2019.
  • States with integrated LTSS programs have demonstrated progress toward improving quality of life and satisfaction for participants, reducing waiver waitlists, and increasing budget predictability.

“As states look for effective and comprehensive solutions for quality services, they are increasingly looking to integrated LTSS programs, including for the I/DD population, because of improved outcomes and patient satisfaction. The data demonstrates this approach creates a more seamless experience of care for beneficiaries and providers, improving health and well-being,” said HMA Principal Stephen Palmer.

The reports also highlight concrete, positive outcomes from integrated LTSS programs across the country, including for the I/DD population:

  • When Tennessee launched the Employment and Community First CHOICES program (ECF CHOICES) to integrate LTSS for I/DD into the state’s existing Managed Care program, more individuals with I/DD registered for HCBS within 20 months of the program’s launch than in the previous 6 years.
  • The Tennessee program is designed to facilitate employment and independent living for the I/DD community – 26% of beneficiaries in the ECF CHOICES Managed Care program are employed, compared to only 17% of those in the fee-for-service program.
  • In Kansas, the KanCare program increased primary care physician visits for beneficiaries receiving integrated LTSS services by 80%, decreased costly hospital stays by 29%, and decreased emergency department use by 7%. Non-emergency transportation also creased by 56%, suggesting KanCare beneficiaries were attending more appointments with providers.
  • In a multi-state study, integrated LTSS enrollees had 28% higher odds of responding favorably to questions related to experience of care and quality of life compared to fee-for-service beneficiaries.

“Arizona for Better Medicaid looks forward to discussing the findings in these reports with health care stakeholders across the state as we continue to seek solutions that provide better access, experiences and outcomes for Arizonans,” concluded Nava.

The full reports can be found here. To learn more about Arizona for Better Medicaid, please visit

You can find Arizona for Better Medicaid on Twitter, Facebook and LinkedIn.

About Arizona for Better Medicaid

Arizona for Better Medicaid is a multi-stakeholder group of organizations committed to building a better Medicaid system that improves access, quality, outcomes and affordability by fully integrating Managed Care in Arizona. Arizona for Better Medicaid’s members include health care leaders, providers, health plans and others who are champions of Medicaid and Medicaid Managed Care. Learn more at

About Health Management Associates

The HMA team is over 225 colleagues strong and growing, with experience that spans the healthcare industry and stretches across the nation. Dedicated to serving vulnerable populations, HMA successfully tackles a wide variety of healthcare issues, working directly with federal, state, and local government agencies, health systems, providers, health plans, foundations, associations and others to effect change. Our colleagues have held senior level positions in medical and behavioral health provider systems, public health agencies, community-based organizations, state and federal agencies, managed care and accountable care organizations. We offer a breadth and depth of experience we believe is valuable to our clients in helping them achieve their goals and effect change. Founded in 1985, HMA is a private, for-profit “C” corporation, incorporated in the State of Michigan in good standing and legally doing business as Health Management Associates, Inc.


Bettina Nava, Arizona for Better Medicaid,, (602) 228-0105

Stephen Palmer, Health Management Associates,