The next big savings opportunity for managing Medicaid costs is Managed Medicaid Long-Term Care (LTC). Long-term care costs account for 34 percent of the Medicaid budget nationwide. With baby boomers aging, long-term care enrollment will only grow. Different states have tried different programs to manage this cost and it is working well in some states, but not so well in others. Actuaries are often asked to help design viable Managed Medicaid long-term care programs, determine the financial viability of programs for managed care companies, and of course, set the rates for these programs as required by CMS’s need for an actuarial certification. This session will describe the intricacies and design of Managed Medicaid long-term care programs, provide information on what has historically worked to save costs and what hasn’t, and detail items to consider and understand when setting actuarially sound rates for these programs. You should expect to leave the session with a deeper understanding of the existing state Managed Medicaid LTC programs, rating issues faced by actuaries in these programs and the ability to identify strategic opportunities for your company or clients.