Over the past decade, Managed Long-Term Services and Supports (MLTSS) programs have progressively influenced how care is delivered to older adults who simultaneously qualify for Medicare and Medicaid. The increasing adoption of MLTSS by state Medicaid programs signifies a pivotal shift in addressing the needs of this population, promising enhanced support and resources for caregiving. This article dissects recent trends illuminated by a study spanning from 2012 to 2022, highlighting noteworthy changes in the caregiving landscape for older adults.
Growing Adoption of MLTSS Programs
The study used data from the National Health and Aging Trends Study (NHATS) linked with county-level MLTSS program data, focusing on adults aged 70 years or older who are dually enrolled in Medicare and Medicaid. From 2012 to 2022, there has been a marked increase in the proportion of older adults residing in areas with MLTSS programs—from 39.4% in 2012 to 71.4% in 2022. This enlargement indicates a broadening implementation of MLTSS, emphasizing its role in enhancing care services.
Impacts on Caregiver Dynamics
Older dual enrollees residing in areas with continuous MLTSS program presence show a higher mean weekly care hour allocation, receiving significantly more support compared to those in non-contributing or newly implementing areas. This support primarily comes from unpaid family caregivers, who continue to dominate the caregiving landscape, offering an average of 42.0 care hours per week. Although paid caregiving has seen a rise, with mean hours increasing significantly from 2012 to 2022, unpaid caregiving remains pivotal.
Key takeaways from the study highlight the following:
• A significant rise in the percentage of older adults receiving MLTSS support.
• Unpaid family caregivers provide the majority of care hours.
• Areas with long-term MLTSS programs show a steady increase in paid caregiver hours.
While the presence of MLTSS programs has bolstered support available to older adults, unpaid caregiver reliance persists. The study underscores the crucial need for systems to monitor these programs’ impacts comprehensively. Implementing robust support structures for both caregivers and care recipients ensures sustainability and effectiveness of the assistance provided. Policymakers and healthcare planners must continue to focus on maximizing MLTSS benefits, ensuring the balance between family and paid caregiving resources, and enhancing overall care quality for older adults.
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