Millions of Americans, including older adults and people with disabilities or chronic illnesses require long-term services and supports (LTSS) to complete their daily routines. Medicaid is the primary payer across the nation for LTSS and provides coverage through several vehicles and over a continuum of settings. The cost of LTSS and how these services are delivered is going to be an increasingly important question in the years to come. This session will explore the current environment and future of LTSS. Speakers will discuss current issues and trends including MLTSS quality measures, the evolution of long term care from institutional to home and community settings, the Money Follows the Person Demonstration, consumer direction, and the evolution and status of key CMS regulations.