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Target Populations

Key Considerations

In any given state, the universe of persons using LTSS can be divided into several subgroups.  Below are a number of key questions to consider when identifying specific concerns and issues for each of these beneficiary populations:

  • Age: Are children included?  Adults 18-64?  Persons 65 and older?

  • Disability: Are you including persons with intellectual disabilities?  Physical disabilities? Sensory impairments?  Age-related loss of function? Serious mental illness?

  • Setting of care: Are you including persons in residential settings?  Long-term nursing facilities or intermediate care facilities? Persons in state-operated facilities?

  • Level of care need: Are you including persons who meet the institutional level of care criteria?  Persons who do not meet the institutional level of care criteria?  Both?  If you are designing an integrated program that includes primary and acute care, are you including persons who do not have documented LTSS needs?

  • Program eligibility: Are you including Medicare-Medicaid beneficiaries or only those with Medicaid?  Are you including persons who do not qualify for Medicaid but receive state-funded LTSS? Will people with Medicaid plus private insurance (Third-Party Liability or TPL insurance) be eligible to enroll?
Click the worksheet for target populations questions to aid in the design of your MLTSS program. Worksheet 4.2



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