Improving the Balance: The Evolution of Long Term Services and Supports, FY 1981-2014
This historical expenditures report and corresponding state-by-state data tables document three decades Medicaid Long Term Services and Supports (LTSS) systems transformation from primarily institutional services to the present, where home and community-based services (HCBS) are a majority of LTSS spending. These reports include Medicaid expenditures for all LTSS, including institutional services and HCBS, by service category and state. The data comes primarily from the Centers for Medicare & Medicaid Services (CMS)-64 reports.
- Improving the Balance: the Evolution of LTSS Expenditures
- Data Tables
Long Term Services and Supports Annual Expenditures
The most recent Medicaid LTSS expenditure reports document the decades-long growth in HCBS, which now are a majority of LTSS expenditures. These reports include Medicaid expenditures for all LTSS, including institutional services and HCBS, by service category and state. The data comes primarily from CMS-64 reports.
- LTSS Expenditure Report 2019
- LTSS Expenditure Report 2017 and 2018
- LTSS Expenditure Report 2016
- LTSS Expenditure Report 2015
- LTSS Expenditure Report 2014
- LTSS Expenditure Report 2013
- LTSS Presentation 2013
- LTSS Expenditure Report 2012
- Selected Characteristics of 10 States With the Greatest Change in Long-Term Services and Supports System Balancing, 2012–2016
Medicaid Expenditures for Section 1915(c) Waiver Programs
This report, a companion to the LTSS expenditures report, highlights the subset of LTSS spending that comes specifically from 1915(c) HCBS waivers. Like the LTSS expenditures report, this report is based on the CMS-64 and therefore includes expenditures only. State and national data are included. CMS no longer produced a standalone report on Medicaid expenditures for section 1915(c) waiver programs. The most recent expenditure data on section 1915(c) waiver programs is available within the LTSS Expenditure Report 2017 and 2018. Additional information on section 1915(c) waiver programs is also available in the reports under “Medicaid Section 1915(c) Waiver Program Data Based on the CMS 372 Report” below.
- 1915c Expenditure Report FFY2016
- 1915c Expenditure Report FFY2015
- 1915c Expenditure Report FFY2014
- 1915c Expenditure Report FFY2013
- 1915c Expenditure Report FFY2012
- 1915c Expenditure Report FFY2011
Medicaid Section 1915(c) Waiver Program Data Based on the CMS 372 Report
This report summarizes data about section 1915(c) waiver programs submitted by states on the CMS 372 report. The CMS 372 identifies the number of people who received HCBS waiver program services, and Medicaid expenditures. Because the data source is different, the expenditures reported here are not exactly the same as those reported in the CMS-64 reports. State and national data are included.
- 2017-2018 Section 1915c Beneficiary and Expenditure Report
- 2015-2017 Section 1915c Beneficiary and Expenditure Report
- 2014-2015 CMS 372 Report
- 2013-2014 CMS 372 Report
- 2012-2013 CMS 372 Report
- 2011-2012 CMS 372 Report
- 2010-2011 CMS 372 Report
- 2009-2010 CMS 372 Report
Long-Term Services and Supports Beneficiaries
The most recent Medicaid LTSS user brief updates previous reports estimating the number of people who receive Medicaid LTSS. The latest brief documents the number of individuals in each state who received Medicaid-funded LTSS based on the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF). The TAF are a comprehensive national dataset on beneficiary enrollment and service use for Medicaid and the Children’s Health Insurance Program (CHIP). State and national data are included.
Previous Medicaid LTSS beneficiaries reports document the number of individuals in each state who received Medicaid-funded LTSS based on the Medicaid Analytic eXtract (MAX), TAF’s predecessor. These reports include data for three age groups: children, adults age 22 through 64, and older adults. With some exceptions, state and national data are included.