Long-Term Services and Supports

Medicaid is the nation’s largest payer for long-term services and supports (LTSS). State Medicaid programs must cover services provided in nursing facilities as well as home health services (e.g., nursing services). States also cover other LTSS on an optional basis, including home and community-based services (HCBS) and services provided in intermediate care facilities for individuals with intellectual or developmental disabilities.  States can include HCBS in their Medicaid benefit package using both state plan and waiver authorities.

LTSS accounts for a substantial share of Medicaid spending; in fiscal year (FY) 2015, Medicaid spent $158 billion on LTSS, accounting for almost one-third of Medicaid benefit spending.

More content coming soon.

Featured publications

Medicaid Home and Community-Based Services: Characteristics and Spending of High-Cost Users

June 2018 | ,

Medicaid enrollees increasingly are receiving long-term services and supports (LTSS) through home and community-based services (HCBS). This fact sheet describes the characteristics and service use of Medicaid enrollees who used HCBS in 44 states in 2012, and analyzes Medicaid spending for these HCBS users. We focused particularly on high-cost users, defined as the 3 percent […]

Managed Long-Term Services and Supports: Status of State Adoption and Areas of Program Evolution

June 2018 |

Chapter 3 offers a status report on state adoption of managed long-term services and supports (MLTSS). State Medicaid programs increasingly use managed care as one of several strategies to improve care coordination and manage spending for populations with complex health care needs and disproportionately high Medicaid expenditures. As states gain experience with MLTSS, attention is […]

Comments on Money Follows the Person Rebalancing Demonstration Report to the President and Congress

March 2018 |

In late March 2018, MACPAC wrote to the chairmen and ranking members of the Senate Finance and House Energy and Commerce Committees and the Secretary of the U.S. Department of Health and Human Services, commenting on the Secretary’s final report on the Money Follows the Person (MFP) demonstration program. In its comments, the Commission observed […]