This week, our In Focus section reviews two proposed statewide Medicaid managed long-term services and supports (MLTSS) program designs. Alabama is currently accepting public comments on a plan to implement provider-driven Integrated Care Networks (ICNs) to provide MLTSS statewide to roughly 25,000 beneficiaries who are residing in nursing facilities or receiving home and community based services (HCBS) through three of the state’s Medicaid HCBS waiver programs. Meanwhile, Ohio Governor John Kasich proposed in his upcoming state budget to implement a statewide MLTSS program for more than 100,000 beneficiaries in the state. We review both states’ plans for MLTSS, including market sizes, implementation timing, and existing Medicaid managed care plans in the states.