The Impacts of Medicaid’s Managed Long-Term Services and Supports on Health Outcomes in Medicare

Ajin Lee (), Maya Rossin-Slater (), Becky Staiger () and Amanda Su ()
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Ajin Lee: University of California - Riverside
Maya Rossin-Slater: Stanford University
Becky Staiger: University of California - Berkeley
Amanda Su: Stanford University

No 18628, IZA Discussion Papers from IZA Network @ LISER

Abstract: An aging US population has raised important questions regarding the organization, delivery, and funding of long-term services and supports (LTSS), prompting many state Medicaid programs to shift from fee-for-service to managed care models for LTSS delivery. We analyze the effects of transitioning to managed LTSS (MLTSS) on health outcomes among dual-eligible Medicare-Medicaid beneficiaries aged 65 and older in Florida and New York. Using Medicare claims data and a differences-in-differences design leveraging county-by-county MLTSS rollouts, we find that MLTSS leads to a 4.2 percent increase in hospitalizations in Florida, but no significant change in New York. Analysis of preventive care suggests that declining flu vaccination rates in Florida may have contributed to increased hospitalizations from respiratory causes. These findings highlight important differences in MLTSS effects across states and underscore the value of Medicare data for measuring health effects in the dual-eligible population.

Keywords: long-term services and supports; Medicaid managed care; dual-eligible population (search for similar items in EconPapers)
JEL-codes: H51 H75 I13 I18 (search for similar items in EconPapers)
Date: 2026-05
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