Money Follows the Person 2013 Annual Evaluation Report

Publisher: Cambridge, MA: Mathematica Policy Research
Feb 25, 2015
Carol V. Irvin, Noelle Denny-Brown, Alex Bohl, John Schurrer, Wilfredo Lim, Rebecca Sweetland Lester, and Victoria Peebles

Key Findings:

  • By the end of calendar year 2013, MFP programs had cumulatively transitioned 40,693 individuals, and these participants had incurred at least $63 billion in qualified home and community-based services (HCBS) expenditures.
  • Medicaid and Medicare total expenditures decline, sometimes substantially so, during the first 12 months after someone transitions from institutional care to HCBS. MFP participants with physical disabilities or mental illness had higher post-transition total expenditures than a matched set of people who transitioned to the community outside the MFP program. The higher post-transition total expenditures are primarily attributable to higher HCBS expenditures, reflecting the design of the MFP program.
  • After the transition, MFP participants have greater average HCBS expenditures compared with other transitioners with similar characteristics, but typically have lower post-transition Medicaid and Medicare medical care expenditures. Thus, MFP participants’ higher HCBS expenditures are partially offset by the higher medical expenditures the other transitioners incur.
  • Inpatient care and emergency department use, both potentially high-cost services, however, do not explain the differences in post-transition medical care expenditures between MFP participants and those who transition without the benefit of the MFP program. The likelihood of using these services after transition was not significantly different between MFP participants and other transitioners with similar characteristics.
The Money Follows the Person (MFP) demonstration program represents a major federal initiative to give people needing long-term services and supports (LTSS) more choice about where they live and receive care, and to increase the capacity of state long-term care systems to serve people in community settings. Calendar year 2013 marked the sixth full year of implementation of the national MFP demonstration. Cumulative MFP enrollment increased to more than 40,000 transitions by the end of December 2013, a 35 percent growth over the total number at the same point in 2012. As of December 31, 2013, 47 states had received MFP grants, although only 45 states are implementing a program.