As a vital health care safety net program, Medicaid pays for over 40 percent of the nation’s long-term care costs, making it a major source of financing for long-term care services. The long-term care population–about six percent of the Medicaid enrollees—accounts for almost half of total Medicaid program spending. Furthermore, the demand for Medicaid long-term care is expected to swell as the baby boomers age and states increasingly focus on delivering patient-centered services and supports. These trends will continue to put pressure on states to implement more effective and efficient programs to deliver appropriate and timely care to members.

NAMD supports measures that lead to more sustainable, quality-driven solutions to meet the diverse long-term care needs of our citizens’ across the continuum of care. Several states have long histories and valuable experiences operating managed long-term services and supports programs. Their experience demonstrates that managed care can be an effective tool to improve quality, control costs, and drive a member-centered approach to services and desired outcomes.

Based on the lessons learned from those states, NAMD has developed guiding principles and recommendations for federal policymakers to consider in creating a framework for states seeking to design, implement, and administer managed long-term services and supports programs. A strong and effective federal-state partnership with clearly aligned goals is critical to the success of these efforts.

NAMD Submits Comments on New Direction for CMMI

On November 20, NAMD submitted comments to a CMS Request for Information regarding future directions for the Center for Medicare and Medicaid Innovation (CMMI). NAMD calls for a stronger partnership between states and CMMI to promote further demonstration and alternative payment model alignment, and provides several specific issue areas where this partnership can be applied […]


On March 1, NAMD and our sister state associations, the National Association of States United for Aging and Disabilities (NASUAD) and the National Association of State Directors of Developmental Disabilities Services (NASDDDS), sent a joint letter to CMS calling for states to play a prominent role in the future development of any Program of All-Inclusive […]

NAMD Submits Comments on Future of HCBS

On January 9, NAMD provided comments in response to a CMS Request for Information seeking stakeholder input on a variety of questions addressing the provision of Medicaid home and community-based services (HCBS). In the comments, NAMD calls for CMS to be mindful of states’ unique role in HCBS program administration and the continually evolving HCBS […]

NAMD Legislative and Regulatory Priorities for 2017

NAMD’s legislative and regulatory priority documents outline opportunities to modernize the federal rules governing Medicaid to ensure these comport with the realities and expectations for states to run high performing Medicaid programs. NAMD believes these modernizations – in federal statute and in federal regulation – can have a meaningful, positive impact for Medicaid enrollees. See […]

NAMD Responds to Senators’ Revised ACE for Kids Proposal

NAMD provided comments to the Senate authors of a revised version of the Advancing Care for Exceptional Kids Act. Read full letter.