The Role of Medicaid Managed Care in Long Term Services and Supports
Introduction
In Medicaid, long term services and supports (LTSS) refers to the services and supports enrollees of all ages receive to help them with functional limitations and/or chronic illnesses. LTSS also provides enrollees with assistance with performing activities of daily living (ADL) like bathing, grooming, dressing, meal preparation, eating, and medication assistance. Services can be provided in a range of settings, including nursing homes, assisted living facilities, convalescent homes, and home and community-based settings.
In 2016, combined federal and state Medicaid expenditures for LTSS were $167 billion – approximately 30% of total Medicaid spending. Over $95 billion (57%) of total LTSS expenditures were spent on home and community-based services (HCBS). Each year, millions of Medicaid enrollees of all ages use the full spectrum of LTSS, from nursing home care to home-based services. However, medical care and LTSS are very different. LTSS is not curative care; it is a combination of supports and services that help people carry out their daily activities.