States that have been the most successful in transforming their systems of long term services and supports to be primarily provided in the community have tackled reforms on multiple forms. They have streamlined entry in to community services programs to make them as accessible as institutional care; made effective use of technology to help individuals access and coordinate needed supports; controlled the growth of both community and institutional spending; and have begun to better integrate the delivery of long term and chronic care. Other states across the country are looking to the leader states for strategies they can apply to reforming their systems.
NASHP’s work in long term and chronic care delivery systems analyzes state initiatives in order to advance promising practices that could be adopted more broadly by states. We have also conducted assessments of the factors that are limiting further progress on delivery systems reforms and have recommended changes in federal financing of long term services and supports and ways to better coordinate the Medicare and Medicaid programs of behalf of dual eligibles.
