Understanding Medicaid’s Money Follows the Person (MFP) demonstration.
This past week, the Centers for Medicare & Medicaid Services (CMS) announced that it would be expanding its Medicaid’s Money Follows the Person demonstration.
The program apparently has provided billions to help seniors and people with disabilities to safely transition from institutional care to homes and back to their communities. I had not heard of this program, and thus was surprised that it was being expanded.
The demonstration started as a pilot in 2006, then kicked off in a full demonstration effort which ran from 2008-2020 to support home and community-based services (HCBS) and reduce the use of institutional based care. During that time, more than 107,000 transitions were made out of institutional settings through a variety of different interventions. Many of the states have selected their own name for this funding program, which may be why there is a lack public recognition. States such as Pennsylvania, Kansas, and Missouri have coined the name for their MFP program “Finding Home” while other states have used the name, “My Place” or “Returning home.”
In the Consolidation Appropriations Act of 2021, an additional $5 million was awarded to states that were not previously participating in this program to access MFP funds which is run through the state’s government offices. This program has removed restrictions for Medicaid members to receive support for appropriate and necessary long-term services and supports people in the settings of their choice to secure stable housing and reduce risk of institutionalization, which includes unnecessary hospitalizations.
On March 31, 2022, the program was expanded to the current MFP grantees that they will receive increased reimbursement for these services with zero state cost share requirements. Yes, free federal money to support Medicaid members for community based and housing support services (HCBS).
Then last week, an additional $25 million, $5 million per awarded state, was awarded to expand programs in Illinois, Kansas, New Hampshire, American Samoa, and Puerto Rico. The funds will go towards establishing planning partnerships with community stakeholders, conducting assessments to better understand how HCBS supports residents, developing community transitions programs, enhancing HCBS quality initiatives, and recruiting additional staff and technology to support the infrastructure of these programs.
To date there are 41 states and territories participating in this program which is funded through 2025. Please check out the link and select the awarded grantees tab to see if your state is participating, who your contact is, and what requirements are needed for accessing these funds.
If you all are familiar with my recent webcast Long-Stay Hospitalizations: Managing the Complex Patient Populations, we discussed what to do with complex patients who have multiple ED utilization or long stay hospitalizations. Upon researching some of the state programs it appears that this is a program that hospital and outpatient community-based case management programs should be aware of and could access to support their complex patient population.
Although each state is unique, the program is routed typically through two areas the Office of Aging and Adult Services and the Office for Citizens with Developmental Disabilities. To meet the institutionalization criteria, the client and/or patient would need to have a length of stay of at least 60 days. However, in today’s current conditions and with true complex cases, this is not unheard of with social admissions in the hospital, NICU babies, or psychiatric patients.
Once eligibility is established, they would be able to access MFP funds to support transitions into less restrictive community-based housing depending on patient needs. These funds could also help support initial payments and coordination of services to transition the patient out of the institutional setting.
Monitor Monday listeners were asked if any of the listeners were familiar or if they had utilized their state-run Money Follows the Person program (i.e., Finding Home, My Place)?
The responses from the Monitor Monday listener survey may surprise you, and can be viewed here.
Programming Note: Listen to Tiffany Ferguson live reporting on the SDoH every Monday on Monitor Mondays at 10 Eastern.
References:
Money Follows the Person | Medicaid
The Centers for Medicare & Medicaid Services (CMS) has published several new proposed rules regarding Medicare payments for 2025. In addition to updating payment rates,
The Centers for Medicare & Medicaid Services (CMS) has recently taken significant steps to enhance the Medicare Prescription Payment Plan by issuing final guidance and
Please log in to your account to comment on this article.
ICD10monitor has teamed up with renowned CDI expert Dr. Erica Remer to bring you an exclusive webcast on how to recognize sepsis, how to get providers to give documentation that will support sepsis, and how to educate to avert sepsis denials. Register now and become a crucial piece of the solution to standardizing sepsis clinical practice, documentation, and coding at your facility.
Optimize your inpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. Participants will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Join expert Angela Comfort, MBA, RHIA, CDIP, CCS, CCS-P., as she helps you navigate advanced inpatient CDI technologies, regulatory changes, and system interoperability. Angela will provide actionable strategies for integrating AI and predictive analytics into CDI practices, ensuring seamless system interoperability, and maintaining compliance with evolving regulations. Attendees will learn to select and implement advanced EHR systems and CDI software, leverage data analytics to enhance documentation accuracy, and stay audit-ready with the latest compliance updates. Real-world case studies and practical tools will empower you to drive continuous improvement in CDI, improve patient outcomes, and enhance organizational efficiency. Don’t miss this opportunity to advance your CDI practices and stay ahead in this dynamic field.
Join expert Angela Comfort, MBA, RHIA, CDIP, CCS, CCS-P, for an insightful webcast on improving inpatient clinical documentation integrity (CDI). Inaccurate documentation can lead to misdiagnosis, improper treatment, and compromised patient safety. High workloads, lack of standardized practices, and outdated EHR systems contribute to these issues, affecting care quality and financial outcomes. Angela will offer practical strategies and tools to enhance accuracy, consistency, and timeliness in documentation. Attendees will learn to use standardized templates, checklists, and advanced EHR systems, while staying compliant with regulations. Improve patient care, ensure accurate billing, and reduce audit risks with actionable insights from this essential webcast.
This webcast, presented by Tiffany Ferguson, LMSW, CMAC, ACM, addresses the critical gap in Social Determinants of Health (SDoH) reporting for pediatric populations. While SDoH efforts often focus on adults, this session emphasizes the unique needs of children. Attendees will gain insights into the current state of SDoH, new pediatric Z-codes, and the importance of interdisciplinary collaboration. By understanding and applying pediatric-specific SDoH factors, healthcare professionals can improve data capture, compliance, and care outcomes. This webcast is essential for those looking to enhance their approach to pediatric SDoH reporting and coding.
Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, VP of CDM, for a webcast addressing oncology service coding challenges. Learn to navigate coding for infusions and injections alongside Evaluation and Management (E/M) services, ensuring compliance and accurate reimbursement. Gain insights into documenting E/M services for oncology patients and determining medical necessity. This webcast is essential to optimize coding practices, maintain compliance, and maximize revenue in oncology care.
During this webcast Dr. Ronald Hirsch delves into the inpatient admission order process including when to get it, when it becomes effective, its impact on billing and payment, who can write it, how to cancel it, the effects on the beneficiary, and more. You’ll leave with a clear understanding of inpatient orders and guidelines for handling improper orders that you can implement immediately.
Michelle Wieczorek explores challenges, strategies, and best practices to AI implementation and ongoing monitoring in the middle revenue cycle through real-world use cases. She addresses critical issues such as the validation of AI algorithms, the importance of human validation in machine learning, and the delineation of responsibilities between buyers and vendors.
Copyright © 2024 RACmonitor. Powered by MedLearn Media.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
