Trends In Users & Expenditures For Home & Community-Based Services As A Share Of Total Medicaid Long-Term Services & Supports—Users & Expenditures, 2023

On October 17, 2025, the Centers for Medicare & Medicaid Services (CMS) published these trend in 2023 users and expenditures for home andcommunity-based services (HCBS) as a share of total Medicaid long-term services and supports. This brief presents national and state trends inMedicaid LTSS user and expenditure rebalancing ratios for 2023, based on data from the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF). It also presents national rebalancing ratios by select characteristics, including age, sex, dual-eligibility status, urban or rural residence, primary spoken language, race and ethnicity, and for five LTSS subpopulations, according to . . .