This resource examines Medicaid payment reform strategies for populations who receive LTSS. It includes case studies of state programs in Tennessee, Minnesota, and Arizona. 

• A growing number of states are implementing value-based payment programs to deliver LTSS to Medicaid populations with complex needs.
• Payment models include pay-for-performance, supplemental per-member per month payments, shared savings/shared risk, and episode-based payments.
• Measurement strategies for value-based LTSS payment may need to consider less traditional domains such as quality of life, independence, and functional status.
• States can support and direct value-based strategies in various ways, including grants or capacity-building opportunities for LTSS providers.