Level of Care Needs Among Money Follows the Person Participants

Background: The Money Follows the Person (MFP) program promotes community living for long-term institutionalized Medicaid beneficiaries. Currently, little is known about level of care needs among MFP participants and whether states are using the demonstration to transition individuals who have low care needs or those who have high needs. Who transitions through the MFP program will have important implications for the overall demonstration results. Methods: We linked MFP administrative data, nursing home Minimum Data Set (MDS) records, and Medicaid Analytic eXtract files to identify MFP and non-MFP nursing home residents who transitioned to the community. The MDS-based Resource Utilization Groups (RUG-III) were used to infer pre-transition care needs among long-stay nursing home residents who transitioned to the community during 2008 and 2009. Low care status was defined as requiring no physical assistance in any of the late loss ADLs and designation in any of the three lowest intensity RUG classification groups. (Mor et al. 2007). Results: Preliminary findings indicate that among 3,796 MFP participants who transitioned to the community from a nursing home, 21% were classified as low care. Low care residents had an average age of 62.5 years and ranged from 23 to 95 years. Conclusions: Because the proportion of low care individuals varied widely by state, from 3% to 72%, some states are using the MFP program to transition low need individuals and may be making their long-term care systems more cost effective while others are transitioning individuals with higher needs and testing the capacity of community-based services.