LTQA: A Unique Space in LTSS

LTQA provides a unique space in long-term services and supports (LTSS) where the range of relevant stakeholder groups interact around service delivery reform, quality improvement, financing, and public policy matters. LTQA members represent consumers, providers, payers, researchers, and foundations.

Members of the Alliance gather at the Big Table to bring diverse interests involved in LTSS together and work collaboratively through meetings and events that:

  • Define and communicate the shared interests of the broad LTSS community;
  • Address issues in service delivery; and
  • Articulate a vision for LTSS service delivery reform and financing.

Research, Education, and Advocacy

LTQA advances person-centered, integrated LTSS through research, education, and coordinated public affairs and government affairs efforts. LTQA members work together to identify effective models of LTSS integration, build the business case, catalyze consensus, and encourage broader adaptations for financing LTSS integration.

The Need for LTQA

The movement toward integration of medical care, behavioral health, and LTSS, centered on the person and family, offers a framework for making significant gains on long-standing problems with:

  • Access to home and community-based LTSS;
  • Post-acute care transitions and readmissions;
  • Coordination of medical care and social services and supports;
  • Quality of community-based services; and
  • LTSS financing.

The potential for slowing health care cost growth rests on developing more effective ways to manage care and improve the health of the population with high healthcare needs and costs.

Successful early intervention, targeted on the basis of functional limitations rather than health care needs, can be most effective at lowering costs and improving outcomes. Managing a system of coordinated medical care and social services based on an individual’s own goals and preferences can reduce the need for expensive medical care, lower overall care costs, and improve outcomes.

To make the investment in social services and supports viable financially, however, the added costs of services have to be paired with the reduction in health care spending. Full integration of medical and non-medical services funded by a single capitated premium provides both the incentive and the tools to achieve substantial savings and improve quality of life for high-cost, high-need individuals.

The reality of LTSS integration is a long way from the vision of a fully-integrated future. There are relatively few successful models of full integration available today and few of the models that are successful have the capacity to scale up sufficiently to become a norm for how care is financed and delivered.

Before any of the service delivery improvement and financing solutions dependent on LTSS integration can take place, integration itself needs to become a widespread reality. LTQA’s vision of the path to this future starts with projects that help build the foundation for LTSS integration, help scale up small successful models of LTSS integration, encourage large, well-resourced organizations to pursue LTSS integration on a large scale, and generally accelerate the pace of change toward widespread LTSS integration.


Program Goals:
LTQA’s strategic goal for the five-year period from 2018 through 2022 is the achievement of:

A broader commitment from stakeholders and policymakers to a vision for delivering and financing LTSS in the future around which a wide array of stakeholder groups can coalesce.

In the next three years, LTQA’s will pursue this strategic goal by accomplishing two intermediate tactical goals:

  1. An improved evidence base that can be used to justify investments in integrated LTSS systems – especially investments by established health care plans, accountable health systems (ACOs), and federal and state governments;
  2. Identified roadblocks to advancing integrated care and progress toward reducing them to enable development and operation of successful organizations and programs that integrate person-centered, high-quality, and consumer-empowering LTSS and acute care.

LTQA has adopted several objectives to make progress toward these Tactical Goals over the next three years.   These objectives will guide LTQA’s projects and activities over the next five years (2018 through 2022), as outlined in the chart below:

Strategic Plan 2018-2022


Tactical Goal 1:


Tactical Goal 2:


Short-Term Priorities:

a. Promote evidence from LTQA research of the value (ROI)
of integrated care.

b. Contribute new evidence of the value (ROI) of integrated

c. Develop data on LTSS needs of adults under age 65 with

Long-Term Priorities:

d. Apply evidence to estimate LTSS coverage costs

Short-Term Priorities:

a. Identify policy barriers and promote changes in law to
expand integrated care.

b. Build stakeholder engagement to promote integrated care.

c. Develop approaches to increase supply and retention of
direct care workforce.

Long-Term Priorities:

d. Raise awareness among policymakers of the importance of
LTSS and LTSS integration.

e. Promote data sharing, data interoperability, quality
measurement, and accountability in LTSS programs.