Money Follows the Person Demonstration Program: Helping Medicaid Beneficiaries Move Back Home

Money Follows the Person (MFP) is a federal Medicaid demonstration designed to incentivize states to shift Medicaid long-term care spending from institutional to home and community-based services.  MFP was authorized in the Deficit Reduction Act of 2005 and then extended in the Affordable Care Act through 2016.  Under the demonstration, participating states receive 365 days of enhanced federal funding for qualified services for every Medicaid beneficiary who transitions from an institution to a community-based setting.  Currently, 45 states have received federal MFP demonstration funding.  A companion report, Money Follows the Person: A 2013 State Survey of Transitions, Services, and Costs, summarizes 2013 survey data on enrollment trends, services, and per capita spending and describes the interactions between MFP and new and expanded options under the Affordable Care Act as well as managed care. Two state case studies – Maryland’s Money Follows the Person Demonstration: Supporting Transitions Through Enhanced Services and Technology and Tennessee’s Money Follows the Person Demonstration: Supporting Rebalancing in a Managed Long-Term Services and Supports Model – provide insight into how MFP was incorporated into existing infrastructure and also how MFP supports larger rebalancing initiatives.

Based on personal interviews conducted in August 2013, the profiles of four MFP participants residing in Maryland or Tennessee are presented here to highlight the diverse experiences of persons with LTSS needs who transition from nursing homes to the community. Each of these individuals is dually eligible for Medicaid and Medicare services. Such personal stories add a human dimension to the ongoing conversations among federal and state policymakers about supported transition, community integration, and expanding access to Medicaid home and community-based services.