Long-Term Services and Supports (LTSS)

LTSS encompass a wide range of services designed to help individuals live more independently by assisting with personal and health care needs, including activities of daily living. LTSS providers may coordinate care for Medicaid beneficiaries in their own home or community and provide medical or non-medical services.

In 2018, there were 12.2 million individuals dually eligible for Medicare and Medicaid, and forty-nine percent of these individuals receive long-term care services and supports (LTSS).1,2 Dually eligible beneficiaries are more than twice as likely to use LTSS compared to other Medicaid beneficiaries, and more than five times as likely compared to other Medicare beneficiaries.3 Supporting older adults and people with disability to live in home or in community settings leads to better health and maximum independence.4 Many states are shifting service delivery to managed LTSS (MLTSS) to improve coordination of care for dually eligible beneficiaries. MLTSS refers to the delivery of LTSS through a capitated Medicaid managed care program. This shift allows states to expand home and community-based services, promote community inclusion, ensure quality, and improve efficiency.5 Resources for Integrated Care has created several brief documents for LTSS providers and health plans to help them navigate moving to managed care and develop strong long-term partnerships to deliver coordinated, person-centered, and cost-effective care.

  • Cultural Competence in Long-Term Services and Supports (LTSS)

  • Plan and Provider LTSS Partnerships

1 Medicare-Medicaid Coordination Office. (2020). Medicare-Medicaid Dual Enrollment from 2006 through 2019. Available at: https://www.cms.gov/files/document/medicaremedicaiddualenrollmenteverenrolledtrendsdatabrief.pdf.

2 Medicare-Medicaid Coordination Office. People Dually Eligible for Medicare and MedicaidFact Sheet. (2020). Available at: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/MMCO_Factsheet.pdf.

3 Congressional Budget Office. (2013). Dual-Eligible Beneficiaries of Medicare and Medicaid: Characteristics, Health Care Spending, and Evolving Policies. Available at: https://www.cbo.gov/sites/default/files/113th-congress-2013-2014/reports/44308dualeligibles2.pdf.

4 Centers for Medicare and Medicaid Services. LTSS Overview. Available at: https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/LTSS-TA-Center/info/ltss-overview.

5 Center for Medicare and Medicaid Services (CMS). Managed Long Term Services and Supports. Available at: https://www.medicaid.gov/medicaid/managed-care/managed-long-term-services-and-supports/index.html.