High-need, high-cost (HNHC) individuals are defined as people of all ages living with clinically complex needs and functional limitations who also incur high health care costs or are likely to do so in the near future.

As the population ages, one of the greatest challenges facing state officials is how to organize and pay for long-term services and supports (LTSS) for low-income elderly and disabled adults—the most complex, expensive, and fastest-growing group covered by Medicaid.

Type the phrase “aging in place” into a Google search, and you’ll likely see pictures of wheelchairs fitting comfortably through home doorways, bathtubs and showers with zero-step entrances, and open floorplans to facilitate seamless movement from room to room.

In response to the heightened interest in the relationship between work and the health of individuals and communities, CMCS has clarified that Medicaid funds cannot be used to pay beneficiaries’ wages, but can pay for employment counseling as an optional benefit—to help people get jobs.

On January 1, 2014, in states that have chosen to expand Medicaid eligibility under the Affordable Care Act, nearly all chronically homeless people who lacked health insurance became eligible for Medicaid.