An official website of the United States Government -

Long-Term Services and Supports

Long-term services and supports (LTSS) refers to both institutional care and home- and community-based services (HCBS). Medicaid beneficiaries who use LTSS are a diverse group, spanning a range of ages with different types of physical and cognitive disabilities. They often receive services and supports for many years, or even decades. The types and intensity of services they require vary, both across and within subgroups.

People who receive Medicaid LTSS often have complex conditions and high needs, and thus are among the program’s most expensive beneficiaries.

Trends in LTSS delivery include increasing use of HCBS relative to institutional care, development of new quality measures for HCBS, and the increasing delivery of LTSS through managed care.

Click here for our Medicaid 101 series on YouTube.

Learn More about These Topics

Featured Publications

Demographic Characteristics of Medicaid Beneficiaries Enrolled in the Program of All-Inclusive Care for the Elderly

July 7, 2026

The Program of All-Inclusive Care for the Elderly (PACE) is a fully integrated care model that provides Medicare and Medicaid services to individuals age 55 or older who meet a nursing facility level of care and can live safely in the community at the time of enrollment. In 2023, approximately 89,659 individuals were enrolled in […]

Exploring the Role of the State Medicaid Agency in the Program of All-Inclusive Care for the Elderly

June 15, 2026

Chapter 6 focuses on the Program of All-Inclusive Care for the Elderly (PACE), which provides integrated care to adults age 55 and older who meet nursing facility level-of-care criteria and can live safely in the community. Findings from MACPAC’s June 2025 report to Congress identified questions related to transparency in state and federal oversight of […]

Exploring the Role of the State Medicaid Agency in the Program of All-Inclusive Care for the Elderly: Recommendations and Updated Implications

May 7, 2026

The Program of All-Inclusive Care for the Elderly (PACE) model provides integrated care to adults ages 55 and older who meet nursing facility level-of-care criteria and can live safely in the community. Findings from the June 2025 report to Congress identified questions related to transparency in state and federal oversight of PACE compliance and quality.
At […]