CMS Releases Medicaid LTSS Users and Expenditure Data for 2019-2021

The Centers for Medicare & Medicaid Services (CMS) recently released comprehensive data on Medicaid Long-Term Services and Supports (LTSS) usage and expenditures from 2019 to 2021. This data highlights the continued shift towards home and community-based services (HCBS), with 86.2% of LTSS users receiving HCBS in 2021, and these services accounting for 63.2% of total LTSS spending. The reports also indicate significant variability across states in how they have rebalanced spending toward HCBS versus institutional care. During this period, HCBS spending grew substantially, while institutional service use and expenditures declined. The data also reveals demographic patterns, showing that HCBS users tend to be younger, urban-dwelling, and primarily English-speaking, with a notable proportion from racial and ethnic minority groups relative to those in institutional settings. These findings underscore the importance of HCBS in Medicaid’s LTSS programs and provide valuable insights for policymakers and stakeholders aiming to enhance care for individuals relying on these services.