Research and Evaluation of the Money Follows the Person (MFP) Demonstration Grants

Prepared for
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services
woman in a wheelchair using a chair lift


Many Americans who need long-term care services and supports would prefer to receive them in home- and community-based settings rather than in institutions. Often, decisions relating to the provision of long-term care services are dictated by what is reimbursable under federal and state Medicaid policy rather than by what an individual needs or wants. 

The Money Follows the Person (MFP) Demonstration is a large federal initiative to help states reduce their reliance on institutional care for people needing long-term care, and expand options for elderly people and individuals with disabilities to receive care in the community. Funded at $4 billion over nine years, it is the largest demonstration program of its kind in the history of Medicaid. States use the grant funds to develop systems and services to help long-term residents of nursing facilities, intermediate care facilities for individuals with intellectual disabilities, and psychiatric hospitals who want to move back to home or community-based settings. They also are increasing efforts to shift Medicaid long-term care spending permanently toward community-based care and services. 

Mathematica's comprehensive evaluation for the Centers for Medicare & Medicaid Services (CMS) is assessing how state long-term care systems change to support the transition of people from institutions to the community, whether the changes were successful and sustainable, and to what extent MFP helps rebalance state long-term care spending. The evaluation is also analyzing the effects of MFP on Medicaid beneficiaries' health and quality of life, as well as identifying characteristics of individuals and state programs strongly associated with success. 

As part of the project, Mathematica is also providing technical assistance to CMS and to state grantees. To date, we have supported CMS's review of the detailed operational plans each demonstration program developed and created a web-based semi-annual reporting system in collaboration with Truven Health Analytics. We are now monitoring grantee progress toward benchmarks.