If you or someone you love is currently living in a long-term care facility, but wishing to be enjoying the comforts of home, we have some big news. In September of 2020, The U.S. Centers for Medicare & Medicaid Services (CMS) announced the availability of $165 million, earmarked for states who are operating Money Follows the Person (MFP) demonstration programs. That’s where you or your loved one may come in: MFP programs allow certain Medicaid users to transition from a nursing home back into their own home if they wish. Is this something you could take advantage of?
What is “Money Follows the Person”, and why is it important?
The idea is simple: an individual who qualifies for the services they are receiving should be able to receive those services wherever they wish. Put simply, MFP gives patients a choice in where they live and receive the services they require. It’s a win for many folks, allowing them to continue living life as they have always known it.
According to the data from 2019, people classified as having “physical disabilities” and those in the “older adults” category represented 76 percent of the total number of transitions. What’s great about the MFP program is that it still allows for institutionalized care when appropriate, but it also offers support for patients who aren’t necessarily there yet. It bridges the gap between living at home alone, which can become less safe as we age, and living in long-term care, which isn’t necessary when someone may just need basic help with certain activities of daily living, for example.
One of MFP’s stated goals is to increase the use of home and community-based services (HCBS) thus reducing the use of institutionally-based services. All other goals for MFP have to do with removing barriers to participation, the red tape that can bog programs like these down.
MFP wants to eliminate the roadblocks found in state law, Medicaid plans, and budgets that restrict the use of Medicaid funds. The spirit of the MFP program is that Medicaid-eligible people should be able to receive care in the setting of their choice, so MFP fortifies Medicaid’s ability to provide those all-important home and community-based services. It allows for quality assurance checks in those home-based programs, too.
According to the data from 2019, people classified as having “physical disabilities” and those in the “older adults” category represented 76 percent of the total number of transitions. What’s great about the MFP program is that it still allows for institutionalized care when appropriate, but it also offers support for patients who aren’t necessarily there yet. It bridges the gap between living at home alone, which can become less safe as we age, and living in long-term care, which isn’t necessary when someone may just need basic help with certain activities of daily living, for example.
The MFP program began in 2008, and as of the end of 2019, participating states had transitioned more than 101,000 people back to living and receiving care under their own roof.
One of MFP’s stated goals is to increase the use of home and community-based services (HCBS) thus reducing the use of institutionally-based services. All other goals for MFP have to do with removing barriers to participation, the red tape that can bog programs like these down.
MFP wants to eliminate the roadblocks found in state law, Medicaid plans, and budgets that restrict the use of Medicaid funds. The spirit of the MFP program is that Medicaid-eligible people should be able to receive care in the setting of their choice, so MFP fortifies Medicaid’s ability to provide those all-important home and community-based services. It allows for quality assurance checks in those home-based programs, too.
In which states is MFP being used?
Only those states who participate in MFP-funded Medicaid programs can receive access to the 165 million (5 million per state) from CMS. That means thirty-three states (including the District of Columbia) are eligible to participate: Alabama, Arkansas, California, Colorado, Connecticut, District of Columbia, Georgia, Iowa, Idaho, Indiana, Kentucky, Louisiana, Maryland, Maine, Minnesota, Missouri, Montana, North Carolina, North Dakota, New Jersey, Nevada, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Vermont, Washington, Wisconsin, and West Virginia.
What is this latest announcement about?
CMS hopes the $165 million will incentivize, and enable, a nationwide movement away from long-term care facilities and toward home-based care.
“The tragic devastation wrought by the Coronavirus on nursing home residents exposes America’s over-reliance on institutional long-term care facilities,” CMS Administrator Seema Verma said. “Residential care will always be an essential part of the care continuum, but our goal must always be to give residents options that help keep our loved ones in their own homes and communities for as long as possible.”
“Home and community-based care is not only frequently more cost-effective, but is preferred by seniors and adults with disabilities seeking to maintain the dignity of independent living,” Verma said. “This new federal investment will help states get our loved ones back home.”
It’s not just more cost-effective, MFP can actually save a lot of money. One informal study looked at New Jersey and found that this one state alone could save about $30,000 annually per person if more care was provided at home as opposed to care facilities.
MFP participation is down
In spite of all the perks that come with MFP, state participation numbers are down. Transitions from institutionalized care to home care declined by 46 percent from 2018 to 2019. A number of factors go into that decline, and gaps in the data collected is an important one. In addition to that, several states intend to or will have closed out their program by the end of 2020.
But with a $165 million dollar shot in the arm, CMS hopes to give the MFP program some of the things it needs to really thrive, like quality assurance checks, and a more user-friendly way to utilize the program.
MFP is just too good of an idea to fall by the wayside, so it’s fantastic that CMS has stepped up to support it this way.
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