The Center for Health Care Strategies (CHCS) and Manatt Health has developed a new toolkit that provides a targeted menu of long-term services and supports (LTSS) reform strategies adopted by state innovators that may be replicated by other states. The toolkit identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance their LTSS reforms.


This toolkit highlights several strategies that states are using to deliver high-quality and high-value LTSS in two key areas: (1) rebalancing LTSS to increase the proportion of LTSS provided in community-based settings and (2) integrating LTSS with physical and behavioral health services through managed care. For each strategy identified within the rebalancing and integration sections, the toolkit provides: the impetus, a description, potential implementation mechanisms, results to date, and key lessons. It also offers case studies to illustrate how states have implemented each strategy. The strategies can be mixed and matched, sequenced in different ways, and modified to accommodate state preferences.