Medicaid’s Money Follows the Person Demonstration: Helping Beneficiaries Return Home

Money Follows the Person (MFP) is a federal Medicaid demonstration designed to incentivize states to shift Medicaid long-term services and supports spending from institutional to home and community-based settings.  MFP was first authorized in the Deficit Reduction Act of 2005, and then extended through 2016 in the Affordable Care Act. Under the demonstration, participating states receive one year of enhanced federal funding for home and community-based and transition services for every Medicaid beneficiary who moves from an institution to a community-based setting. Currently, 44 states (including the District of Columbia) are participating in MFP. A companion report, Money Follows the Person: A 2015 State Survey of Transitions, Services, and Costs, summarizes 2015 survey data on enrollment trends, services, and per capita spending and describes the interactions between MFP and new and expanded home and community-based services options under the Affordable Care Act as well as managed long-term services and supports.

Based on interviews conducted in spring 2015, the profiles of five MFP participants residing in Colorado, Iowa, Pennsylvania, and Texas are presented here to highlight the diverse experiences of people with long-term services and supports needs who transition from nursing facilities to the community. These 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. We extend our appreciation to the individuals who helped coordinate the interviews and the MFP participants who so generously shared their time and stories.


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