Long-Term Care

This fact sheet describes how seniors qualify for Medicaid long term services and supports (LTSS), what LTSS covers, how much Medicaid spends on LTSS, and current policy issues.

For 15 years, KCMU and HMA have conducted annual surveys of Medicaid programs across the country. The NAMD has formally collaborated on this project since 2014. This brief provides a look back at the enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care since as well as highlighting more recent data on managed care and delivery system reforms collected as part of this annual survey. Looking ahead, the survey will continue to capture the evolution of the Medicaid program with a focus program changes during economic cycles as well as innovations in payment and delivery system reform.

On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.

This issue brief draws on features of the various existing Medicaid home and community-based services (HCBS) programs to identify key policy questions raised by initiatives to streamline Medicaid HCBS, ameliorate institutional bias, and improve administrative simplification.

This 10-question quiz tests knowledge of Medicaid and long-term care.

This primer provides an overview of the delivery and financing of institutional and community-based long-term services and supports in the United States, highlighting Medicaid’s key role in providing care, quality measurement and evaluation, and recent national reform efforts.

This report summarizes the key participation and spending trends in 2012 for the three main Medicaid Home and Community-Based Services (HCBS) programs – (1) the mandatory home health services state plan benefit, (2) the optional personal care services state plan benefit, and (3) optional § 1915(c) HCBS waiver services. Also highlighted are 2014 state eligibility, enrollment, and provider reimbursement policies.

Since 2008, the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured has periodically surveyed state Money Follows the Person (MFP) programs, conducted state case studies, and profiled the experiences of individual MFP beneficiaries. Based on the information and data collected in our six surveys, we identify some lessons learned from MFP that could inform future Medicaid long-term services and supports rebalancing policies.

This brief profiles five Medicaid long-term services and supports beneficiaries who transitioned back to the community as participants in the Money Follows the Person demonstration program in Colorado, Iowa, Pennsylvania, and Texas.

The Money Follows the Person (MFP) demonstration provides enhanced federal matching funds, allowing states to better support Medicaid long-term services and supports beneficiaries in transitioning from institutions back to the community. This report highlights 2015 MFP enrollment and spending trends and services and supports offered across state MFP demonstrations.