Get Updates
Mathematica’s Early Assessments of the Money Follows the Person Program
Fourth Report Describes Balance of State Long-Term Care Systems Before Implementation
Media Advisory: June 23, 2010
Contact: Amy Berridge, (609) 945-3378
Issue: Often individuals who need long-term care would prefer to receive it in a home- or community-based setting rather than an institution. However, federal and state Medicaid reimbursement policies rather than individual needs often dictate decisions related to providing long-term care services. The Money Follows the Person (MFP) demonstration, a federal initiative launched in 2005 and extended in 2010 as part of the Patient Protection and Affordable Care Act, provides funds to help states transition elderly people and people with disabilities from long-term care institutions to receive care in the community in the setting of their choice.
Study: Mathematica Policy Research is conducting a comprehensive evaluation of MFP to assess how state long-term care systems change to support the transition of people from institutions to the community, whether states can successfully transition people with significant needs for care, and to what extent MFP helps rebalance state long-term care spending.
Findings: The study’s fourth short report provides an early assessment of the balance of long-term care systems in states before MFP is implemented. By looking at the status of long-term care systems state-by-state, the assessment helps to develop a baseline to measure the program’s impacts. The main findings include:
-
In 2005, of the 2.79 million Medicaid beneficiaries who used long-term care services in MFP grantee states, 60 percent received home and community-based care services (HCBS), yet HCBS accounted for only 38 percent of spending for total long-term care services.
-
There was large variation across states in the relative size of state HCBS programs: expenditures ranged from 13 to 59 percent of total long-term care spending, while the proportion of HCBS users ranged from 24 to 83 percent.
-
Comparing states on a series of measures of long-term care systems revealed important differences in the proportion of long-term care users receiving HCBS, the availability of state plan HCBS, the populations using HCBS, and the receipt of HCBS among new and established users of long-term care.
Quote: “This program aims to transition long-term care users out of institutions and into HCBS settings, so it’s important to establish a baseline of currently existing services,” said Carol V. Irvin, senior researcher at Mathematica and co-author of the report. “We found there were some key differences from state to state in the mix of institutional care and HCBS. Since these long-term care systems started at different points, our study suggests the effects of the MFP program will vary across states, which could have important implications as states look to balance their long-term care systems.”
Report: “The Starting Point: The Balance of State Long-Term Care Systems Before the Implementation of the Money Follows the Person Demonstration.” Carol V. Irvin and Jeffrey Ballou, Reports from the Field #4, May 2010.
About Mathematica: Mathematica Policy Research, a nonpartisan research firm, provides a full range of research and data collection services, including program evaluation and policy research, survey design and data collection, research assessment and interpretation, and program performance/data management, to improve public well-being. Its clients include federal and state governments, foundations, and private-sector and international organizations. The employee-owned company, with offices in Princeton, N.J., Ann Arbor, Mich., Cambridge, Mass., Chicago, Ill., Oakland, Calif., and Washington, D.C., has conducted some of the most important studies of disability, education, health care, international, family support, employment, nutrition, and early childhood policies and programs.