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
Medicaid Hospice: Policy, Utilization, and Oversight
October 29, 2026
Hospice care provides services and support to individuals with terminal illnesses and their families, with a focus on comfort and quality of life. Although hospice has been studied extensively in Medicare, considerably less is known about Medicaid’s role in financing and delivering hospice care, including the populations served, state policy choices, utilization and spending, and […]
Ensuring Health and Welfare in Self-Directed Home- and Community-Based Services: Findings and Policy Option
September 24, 2026
In recent years, the Commission has explored self-directed home- and community-based services (HCBS) as a delivery model for beneficiaries who receive long-term services and supports (LTSS) in their homes and communities. When offering HCBS, including self-directed HCBS, states must ensure beneficiary health and welfare per federal regulations. These federal policies balance beneficiary safety and dignity. […]
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 […]