Money Follows the Person


UPDATE: Funding for the Money Follows the Person and the HCBS Spousal Impoverishment Provisions Extended Until the End of 2019

On August 6th, President Trump signed into law the Sustaining Excellence in Medicaid Act of 2019 (H.R. 3253) which provides extensions of the MFP provision and the HCBS Spousal Impoverishment provision only until the end of 2019.  H.R. 3253, originating in the House, was previously known as the Empowering Beneficiaries, Ensuring Access and Strengthening Accountability Act or the EMPOWER Care Act.  In June, the House passed H.R. 3253 and the Senate took the House bill up at the end of July, passing an amendment in the nature of a substitute. This renamed the bill the “Sustaining Excellence in Medicaid Act of 2019” and changed the original proposed MFP and HCBS Spousal Impoverishment provisions.  

While we are relieved that funding for both provisions was extended until the end of the year, we need to continue pushing for long-term funding extending into 2020 and beyond.  Please see below how you can support the extensions of these important programs.

Support the EMPOWER Care Act to Extend MFP.  

The Money Follows the Person (MFP) Program has helped more than 90,000 seniors and people with disabilities move out of nursing homes and other institutions and into the community. MFP has improved the lives of older adults and people with disabilities, saved states money, and led to better outcomes. That’s why nearly every state has participated in the program! 

Take action and urge Congress to continue to fund MFP!


The Money Follows the Person (MFP) Demonstration – first authorized in the Deficit Reduction Act of 2005 with strong bipartisan support and signed into law by President Bush – was designed to assist states with: (1) supporting Medicaid enrollees who want to transition from nursing facilities back to community-based settings; and (2) developing infrastructure to promote and enhance access to HCBS.

Impact of Money Follows the Person

  • Since its inception, 44 states have participated and over 88,000 individuals have been transitioned back to the community.
  • According to independent evaluations by Mathematica:
    • Participants report significant and lasting improvements in quality of life and community integration after returning to the community.
    • Findings suggest that after individuals return to the community, their overall Medicare and Medicaid expenditures decrease by roughly 20%.
  • States have made significant progress on “balancing” their long-term services and supports system to enhance access for HCBS, due in part to MFP. In FY05, states only spent approximately 37% of their LTSS expenditures on HCBS. According to the most recent data, states now spend over 53% on HCBS.

Need to Continue

  • While states have made progress, more work is needed. Significant variations remain across states and different populations who need HCBS. For example, HCBS accounted for 75% of spending in programs targeting people with developmental disabilities, compared to only 41% of expenditures for programs targeting older people, people with physical disabilities, and people with serious mental illness.
  • Over 50,000 nursing home residents said they wanted to talk with someone about leaving their facility, but never received a referral to a local agency that could help them, according to recent analyses of Nursing Home Minimum Data Set reporting.
  • States have learned lessons and can share promising practices with other states.

What You Can Do

Urge your Members of Congress to extend the Money Follows the Person Program. 


Additional Resources

Letter to Congressional Leaders Urging Long-Term Extension of MFP (October 2019)

Senate Sign On Letter

House Sign On Letter

Info on Money Follows the Person Program (US Dept of Health & Human Svs.)

Evidence for the Impact of the Money Follows the Person Program (Community Living Policy Center)

Medicaid Spending Drops When Members Transition to Community Care (HealthPayerIntelligence 2018)

Money Follows the Person (MFP) Rebalancing Demonstration: A Work in Progress (National Health Policy Forum)

MFP Demonstration: Overview of State Grantee Progress, January to December 2016 (Mathematica 2017)

Money Follows the Person 2015 Annual Evaluation Report (Mathematica 2017)

Money Follows the Person Demonstration: Overview of State Grantee Progress, January to December 2015 (Mathematica 2016)

Money Follows the Person Demonstration Program: Helping Medicaid Beneficiaries Move Back Home (Kaiser Family Foundation)

EMPOWER Care Act one pager (February 2018)

Congress Should Extend Successful “Money Follows the Person” Demonstration (Center on Budget and Policy Priorities 2018)

MFP Chart February 2018

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