In a report released on August 14, KFF assesses Medicaid spending and utilization for long-term services and supports (LTSS) in both institutional and home and community-based settings (HCBS). Here are some highlights from the findings:

• In 2020, 5.6 million people used LTSS with 72% of those receiving only home and community-based services.
• The average spending for individuals receiving LTSS was about nine times higher than Medicaid spending for individuals not receiving LTSS, with the highest costs associated with people receiving services in nursing facilities or intermediate care facilities (both considered institutional settings).
• The average spending on LTSS recipients was nearly $39,000 per person, while the cost average for individuals not receiving LTSS was under $4,500.
• HCBS costs averaged just over $36,000, while institutional costs averaged more than $47,000.

The article notes both the recently proposed Medicaid access rule’s wage pass through provision and the much-anticipated nursing facility staffing rule as probable cost drivers, should either be enacted. Additionally, the authors note labor shortages plaguing the sector, coupled with the drying up of federal financial infusions from COVID relief that will further increase LTSS program prices tags for states.

Read the full analysis here, or a state-by-state breakdown of utilization is available here.