MLTSS Institute

The MLTSS institute is a collaboration between ADvancing States members and national Medicaid health plans intended to drive improvements in key MLTSS policy issues, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans.

All three focus areas of the Institute include the common themes of: 1) building state agency capacity; 2) fostering innovation at the state level; and 3) providing a feedback loop to the federal policy dialogue.

ADvancing States is pleased to announce the release of a new issue brief, Advancing Equity through MLTSS Programs developed in collaboration with Impact 120. This brief is intended to provide an exploration of how MLTSS programs can address many aspects of equity for LTSS consumers.

Many consumers who require long-term services and supports (LTSS) through Medicaid experience barriers in achieving their highest quality of life, due to the intersectional impact of disability and age, when combined with race, ethnicity, language, sexual orientation, gender identity, and geography.  This report highlights the numerous ways that managed long-term services and supports (MLTSS) programs can enhance state capacity to create more equitable programs for consumers. Research and interviews identified five key themes, which are explored in detail with recommendations for future action:

  1. It’s hard to address equity if we cannot measure it.
  2. Equitable MLTSS programs require a diverse network of culturally competent providers and community partners.
  3. States can use a variety of existing tools to align MLTSS plan efforts with equity-related goals.
  4. To understand inequities, MLTSS plans must authentically engage members through multiple modalities.
  5. Person-centered planning can advance equity by addressing barriers at the individual consumer level.

This is the latest publication from the MLTSS Institute, which serves to drive improvements in key managed long-term services and supports (MLTSS) policy areas, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans.   Since 2016, the MLTSS Institute has published nine issue briefs on topics ranging from MLTSS tools to help address the workforce crisis to state considerations for implementing integrated care programs. 

You can find all MLTSS Institute publications on the Resources page.

State Consulting

As part of the MLTSS Institute, ADvancing States can provide intensive, state-specific consulting on a wide range of MLTSS issues.  These may include:

  • Presentations to state leadership, legislators and providers on national MLTSS trends and implications for state agencies on implementation and oversight.
  • Serving as a national subject matter expert in meetings with key advisory boards and taskforces in the community to chart short- and long-term planning objectives. 
  • Reviewing and providing feedback on quality strategies/measures.
  • Writing or editing state’s managed care authority documents (SPAs or waivers), MLTSS RFPs or MCO contracts.
  • Developing and/or reviewing MCO readiness review tools and recommendations for addressing MLTSS program elements, including participation on readiness reviews if requested. 

MLTSS Institute Advisory Board Members: 




Sharon Alexander
Amerihealth Caritas Family of Companies
President, Long-Term Services and Supports
Michelle Bentzien-Purrington
Molina Healthcare, Inc.
Senior Vice President, Managed Long-Term Services and Supports and Social Determinants of Health
Joseph Billingsley
California Department of Health Care Services
Chief, HCBS Policy Branch
Merrill Friedman 
Elevance, Inc. 
Regional Vice President, Inclusive Policy & Advocacy
Katie Moss 
Tennessee Bureau of TennCare 
Chief, Long-Term Services and Supports 
Jakenna Lebsock
Arizona Health Care Cost Containment System Administration
Assistant Director, Health Care Management
Michelle Martin
UnitedHealthcare Community and State
Senior Policy Director, LTSS
Eunice Medina
South Carolina Department of Health and Human Services 
Chief of Staff