The Changing Medical and Long-Term Care Expenditures of People Who Transition from Institutional Care to Home- and Community-Based Services

This report focuses on the medical and long-term care expenditures for Medicaid beneficiaries who transition from institutional to community-based long-term services and supports (LTSS) and how those expenditures change after the transition. An initial analysis of expenditures finds evidence that total Medicaid and Medicare expenditures decline, sometimes substantially, during the first 12 months after someone transitions from institutional care to home and community-based services (HCBS). For people with physical disabilities or mental illness, Money Follows the Person (MFP) participation is associated with increased post-transition total expenditures, but there is no association between MFP participation and post-transition total expenditures for older adults or people with intellectual disabilities.