News

Content provided by UnitedHealthcare Community & State District of Columbia

November is National Long-Term Care Awareness Month, and the UnitedHealthcare Dual Choice Plan offers a wide range of benefits to eligible enrollees who reside in the District. Long-term services and supports (LTSS) refers to a broad range of medical, functional, and social services that are needed by individuals who have complex health needs due to aging, chronic illness, or disability. These services can be provided in a range of settings, including nursing homes, assisted living facilities, convalescent homes, and home and community-based settings. Medicaid serves as the largest payer for LTSS. The need for LTSS is generally measured by limitations in one’s ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs), both of which allow individuals to live independently in their communities.

LTSS are delivered in a variety of settings, including home- and community-based settings (e.g., adult day services and personal care/homemaker services) and institutional care (e.g., intermediate care facilities for people with intellectual and developmental disabilities and nursing homes).

LTSS programs are administered either in nursing facilities or through Home- and Community-Based Services (HCBS). HCBS support people as they continue to live in their home or a setting of their choosing. Individuals who receive HCBS still make appointments and go to a medical facility for care, but they also receive wraparound services in their community or directly in their home.

Approximately 14 million individuals need LTSS in the United States today. Most of these individuals want to stay in their residence for as long as possible, making HCBS the more desirable choice for many individuals needing LTSS. HCBS also offer considerable cost savings for states, with nursing home care costs 73% greater than the cost of care in the community.