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Implementation Challenges and Milestones

Implementing an MLTSS program can be challenging, especially if your state has not previously enrolled older persons or persons with disabilities into any type of managed care program. 

To assess how difficult implementation might be in your state, ask yourself these questions:

  • How much managed care expertise and experience is there at the state administrative and service delivery levels? 
  • How will you address stakeholder concerns? 
  • What role do you anticipate for existing state agencies and units with responsibilities for LTSS services or populations?
  • What role do you anticipate for local LTSS organizations and service providers?
  • How will you develop a payment method that achieves your program goals?
  • How will you communicate with internal and external stakeholders? 
Click the worksheet for related questions to aid in the design of your MLTSS program. Worksheet 2.4

Answering these questions and developing an effective planning and implementation process takes time. How much time depends on the conditions in your state, including experience, infrastructure, and existing relationships with stakeholders. At a minimum, you should plan to spend two years on an MLTSS initiative, including a year of planning and a year of implementation. We have developed an illustrative time line of key milestones as a guide, but you will want to develop your own timeline, based on your knowledge of the current context in your state.

Click on the timeline below to open.Timeline of Key Milestones in MLTSS Program Development


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