Evaluating the Impact of Managed Long-Term Services and Supports on HCBS Providers - Findings from a Seven Wave Survey

Sep 29, 2026

Community HealthChoices (CHC), Pennsylvania’s managed long-term services and supports (MLTSS) program, aimed to improve service coordination, expand access to home and community-based services (HCBS), and sustain provider finances. Findings come from a seven-wave (2018–2024) statewide provider survey conducted by the Medicaid Research Center at the University of Pittsburgh, covering experiences with managed care organizations, implementation satisfaction, financial viability, accessibility, and provider–MCO interactions. Response rates ranged from 19% to 49%, showing evolving provider sentiment, strengthened relationships, persistent perception differences, and improved quality/access over time with regional exceptions.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Background and Program Goals

Study Design and Survey Scope

Outcomes Over Time

Regional Differences and Implications

Recommendations for Future Efforts

894 Innovation in Aging, 2025, Vol. 9, No. S2 Abstract citation ID: igaf122.3024 EVALUATING THE IMPACT OF MANAGED LONG-TERM SERVICES AND SUPPORTS ON HCBS PROVIDERS: FINDINGS FROM A SEVEN WAVE SURVEY Heather Mentch, Keri Kastner, and Howard Degenholtz, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Community HealthChoices (CHC), Pennsylvania’s managed long-term services and supports (MLTSS) program, was designed to improve service coordination, expand access to home and community-based services (HCBS), and ensure provider financial sustainability. This study presents findings from a seven-wave (2018–2024) statewide survey of HCBS providers conducted by the Medicaid Research Center at the University of Pittsburgh. The survey assessed provider experiences with managed care organizations (MCOs), satisfaction with CHC implementation, financial viability, service accessibility, and provider-MCO interactions. Response rates ranged from 19% to 49%, with data analyzed to examine regional trends and provider perspectives. Findings indicate that provider sentiment evolved over time, with initial optimism declining post-implementation before returning to or exceeding pre-implementation levels. While MCO-provider relationships strengthened, there are persistent differences in the rank ordering of perceptions ofMCOs. Providers increasingly recognize the importance of upgrading technology. Providers’ perceptions of quality and access have generally improved over time, with the notable exception of a slight decrease in perceptions of quality in the Southeast. Providers’ expectations regarding financial viability initially declined post-implementation, but have generally improved over time, apart from a recent slight decrease in the Southeast. This multi-year evaluation highlights the complexities Innovation in Aging, 2025, Vol. 9, No. S2 895 of CHC implementation from the provider perspective. While progress has been made in communication, administrative efficiency, and service accessibility, opportunities for improvement related to regulatory burden and financial stability persist. Regional differences suggest that implementation experiences vary, underscoring the need for targeted policy improvements. Future efforts should focus on strengthening provider financial stability and supporting technological improvement.

FAQs

What CHC objectives does the report focus on?

The report highlights improved service coordination, expanded access to HCBS, and ensuring provider financial sustainability.

How was the survey conducted and what years were covered?

It uses a seven-wave (2018–2024) statewide survey of HCBS providers conducted by the Medicaid Research Center at the University of Pittsburgh.

How did provider attitudes change over time?

Provider sentiment initially declined after implementation, then returned to or exceeded pre-implementation levels. Relationships with MCOs strengthened overall.

What challenges and regional exceptions does the report identify?

Opportunities remain related to regulatory burden and financial stability. Quality and financial viability perceptions show slight decreases in the Southeast, and regional implementation experiences vary.

Sep 29, 2026

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