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
Implementation of the American Rescue Plan Act: Additional Support for Medicaid Home- and Community-Based Services during the COVID–19 Emergency
January 15, 2026
The American Rescue Plan Act of 2021 (ARPA, P.L. 117-2), through a temporary increase in the federal medical assistance percentage (FMAP) of 10 percentage points, provided state Medicaid programs with the largest infusion of one-time federal funding for home- and community-based services (HCBS) in recent history. This funding was intended to support states in providing […]
Rate Setting for Medicaid Home- and Community-Based Services
August 19, 2025
Medicaid home- and community-based services (HCBS) are designed to allow people with long-term services and supports needs to live in their homes or a home-like setting in the community. Medicaid is the nation’s largest payer of HCBS for individuals with intellectual or developmental disabilities (I/DD), older adults, and individuals with physical disabilities. In calendar year […]
Spending and Utilization for Medicaid Home- and Community-Based Services
July 24, 2025
Medicaid home- and community-based services (HCBS) are designed to allow people with long-term services and supports (LTSS) needs to live in their homes or a home-like setting in the community. In this brief, we focus on HCBS users and expenditures. This analysis found that, nationally, the number of Medicaid beneficiaries using HCBS increased while the number of institutional LTSS […]