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Long-Term Services and Supports in the Financial Alignment Demonstrations for Dual Eligible Beneficiaries

The Centers for Medicare and Medicaid Services (CMS) and selected states are implementing demonstrations, beginning in 2013, to integrate care and align financing for beneficiaries who are dually eligible for Medicare and Medicaid.  Seven states (CA, IL, MA, NY, OH, SC, VA) are testing a capitated model in which managed care plans will provide and coordinate Medicare and Medicaid acute, physical health, behavioral health, pharmacy, and long-term services and supports (LTSS).  For many dual eligible beneficiaries, the financial alignment demonstrations will be the first time that LTSS will be coordinated with other health care services. This issue brief compares the treatment of LTSS in the seven approved capitated financial alignment demonstrations.