Managed Long Term Services and Supports (MLTSS) Enrollees

Description

1. Enrollment includes both Medicaid-only and Medicare-Medicaid (“dual”) enrollees. For both types of enrollees, Medicaid covers LTSS. For dual enrollees, Medicaid may also cover Medicare cost-sharing for acute, primary care, and specialty services covered by Medicare, and other non-LTSS services that are not covered by Medicare. 2. Some comprehensive managed care programs enroll beneficiaries who may be at risk of needing LTSS but do not receive any LTSS. These counts only include individuals that receive LTSS. Moreover, states differ in their ability to report individuals who use MLTSS versus those who are enrolled (and may or may not be using LTSS). This table reports MLTSS users unless otherwise noted. 3. Comprehensive Managed Care Including LTSS does not include PACE programs. 4. MLTSS Only programs cover LTSS under capitation; acute, primary, and specialty care services for these enrollees may be covered by another Medicaid MCO, Medicaid FFS, or by Medicare for dual enrollees. These data include states that provide MLTSS plus other benefits in a package that does not include inpatient medical care. 5. The indicated territory was not able to supply data for this report. The Northern Mariana Islands reported that they have no Medicaid managed care enrollment, but they did not report total Medicaid enrollees. 6. Enrollment and user counts include both Medicaid-only enrollees and dually eligible individuals. For both types of enrollees, Medicaid covers LTSS. For dually eligible individuals, Medicaid may also cover Medicare cost-sharing for acute, primary care, and specialty services covered by Medicare, and other non-LTSS services that are not covered by Medicare. 7. The “Comprehensive Managed Care Including LTSS” column does not include PACE programs. 8. Columns indicating the "Number of enrollees using LTSS" reflect what states reported. In addition to the three states that reported LTSS users (Arizona, New York and Wisconsin), California and Delaware also offer LTSS services in a stand-alone program. 9. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program. "--" indicates that a state or territory does not operate programs of the type listed in the column heading. Enrollment and user counts include both Medicaid-only and dually eligible individuals. For both types of enrollees, Medicaid covers LTSS. For dually eligible individuals, Medicaid may also cover Medicare cost-sharing for acute, primary care, and specialty services covered by Medicare and other non-LTSS services that are not covered by Medicare. 10. Columns indicating the "Number of enrollees using LTSS" reflect what states reported. In addition to the three states that reported LTSS users (Arizona, New York and Wisconsin), California and Delaware also offer LTSS services in a stand-alone program.

Resources

Name Format Description Link
8 managed-long-term-services-and-supports-mltss-enrollees.2021-tab6.csv https://data.medicaid.gov/sites/default/files/uploaded_resources/managed-long-term-services-and-supports-mltss-enrollees.2021-tab6.csv
8 managed-long-term-services-and-supports-mltss-enrollees2022-tab6.csv https://data.medicaid.gov/sites/default/files/uploaded_resources/managed-long-term-services-and-supports-mltss-enrollees2022-tab6.csv
8 managed-long-term-services-and-supports-mltss-enrollees2024-table6.csv https://download.medicaid.gov/data/managed-long-term-services-and-supports-mltss-enrollees2024-table6.csv

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  • medicaid

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