CMS releases the Medicaid Long-Term Services and Supports (LTSS) Annual Expenditures Report for FFY 2019

Today, the Centers for Medicare & Medicaid Services (CMS) released the Medicaid LTSS Annual Expenditures Report for Federal Fiscal Year (FFY) 2019. This report discusses the LTSS rebalancing trends and growth in expenditures for home and community-based services (HCBS) as compared to institutional spending during the time period reviewed.

Some of the highlights from this report show:

  • Total Medicaid LTSS spending continues to increase. Expenditures increased from $129 billion in FY 2018 to $162 billion in FY 2019.
  • The percentage of HCBS expenditures comprising total Medicaid LTSS expenditures has steadily increased over the last three decades, but it has slowed in recent years.
  • The U.S. total surpassed the long-standing benchmark of 50 percent of LTSS expenditures in FY 2013 and has remained higher than 50 percent since then, reaching 58.6 percent in FY 2019.
  • Nursing facilities represented the greatest share of institutional LTSS expenditures, accounting for 80 percent of these expenditures in FY 2019.
  • Section 1915(c) waiver programs represented the majority of HCBS expenditures in FY 2019, accounting for slightly more than 50 percent of these expenditures.
  • The amount spent on managed LTSS (MLTSS) programs increased more than three-fold in the past 20 years, climbing from $6.7 billion in FY 2008 to $47.5 billion in FY 2019.

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