In this two-part study, the NRCPDS assessed key issues related to participant direction in Medicaid managed long-term services and supports (MLTSS) and integrated Medicare and Medicaid programs for the dually eligible. The NRCPDS reviewed participant direction provisions from requests for proposals, contracts, and other documents related to Medicaid MLTSS programs in 12 states. In addition, they examined the memoranda of understanding and three-way contracts of eight states participating in a financial alignment demonstration for the dually eligible.

This report was developed for the Integrated Care Research Center and contains information which resulted from Contract No. HHSM-500-2010-00026I/HHSM-500-TO003, between Mathematica Policy Research, Inc. and the Centers for Medicare and Medicaid Services under which project the NRCPDS was a Subcontractor.