Statewide Medicaid Managed Care (SMMC) Long-Term Care (LTC) Program
Florida's Statewide Medicaid Managed Care program provides long-term services and supports through a Long-Term Care program that has operated since 2013 as a combined 1915(b) and (c) Waiver program. The LTC program is distinct from its Managed Medical Assistance (MMA) program, an 1115 Waiver program that delivers other healthcare services. Enrollees are able to choose the same managed care organization to provide both types of services, allowing for potential integration of services.
Managed care organizations receive a single, blended capitation rate that depends upon the region of the state and the proportion of members expected to be institutionalized. The proportion is calculated and then reduced to a targeted, lower percentage, and therefore the capitation payment is reduced, on the assumption that plans will work to divert people from institutional placement or transition them out of institutions. MCOs that fail to achieve these targets must either lose money or reduce benefits.
More information
Florida Statewide Medicaid Managed Care home page
NASUAD State Medicaid Integration Tracker page about Florida
Monthly Medicaid enrollment reports (tab LTC has institutional and HCBS participants)
Program documents
SMMC LTC contract with managed care organizations:
Waiver renewal application (draft):
Waiver amendment request:
Original waiver application:
Waiver renewal approval letter:
Florida Comprehensive LTC Assessment:
Medicaid Comprehensive Quality Strategy:
Capitation rates for LTS and MMA services: