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.
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Learn More about These Topics
- Home- and community-based services
- Managed long-term services and supports
- Eligibility for long-term services and supports
- Nursing facilities
- Quality of home- and community-based services
- Who uses Medicaid long-term services and supports?
Featured Publications
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 […]
State Medicaid Coverage of Assistive Technology for Adults Using Home- and Community-Based Services
April 21, 2026
Medicaid home- and community-based services (HCBS) programs are the primary vehicles for Medicaid coverage of assistive technology (AT) for adults. All states and the District of Columbia cover some AT in their HCBS programs serving adults, and the services covered vary. MACPAC conducted a scan of HCBS programs serving adults as of September 2025. Of […]
Compendium: State Medicaid Coverage of Assistive Technology for Adults Using Home- and Community-Based Services
April 21, 2026
Medicaid home- and community-based services (HCBS) programs are the primary vehicles for Medicaid coverage of assistive technology (AT) for adults. All states and the District of Columbia cover some AT in their HCBS programs serving adults, and the services covered vary. MACPAC conducted a scan of HCBS programs serving adults as of September 2025. This […]