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Key Findings:

• By the end of calendar year 2013, MFP programs had cumulatively transitioned 40,693 individuals, and these participants had incurred at least $63 billion in qualified home and community-based services (HCBS) expenditures.
• Medicaid and Medicare total expenditures decline, sometimes substantially so, during the first 12 months after someone transitions from institutional care to HCBS. MFP participants with physical disabilities or mental illness had higher post-transition total expenditures than a matched set of people who transitioned to the community outside the MFP program. The higher post-transition total expenditures are primarily attributable to higher HCBS expenditures, reflecting the design of the MFP program.
• After the transition, MFP participants have greater average HCBS expenditures compared with other transitioners with similar characteristics, but typically have lower post-transition Medicaid and Medicare medical care expenditures. Thus, MFP participants’ higher HCBS expenditures are partially offset by the higher medical expenditures the other transitioners incur.
• Inpatient care and emergency department use, both potentially high-cost services, however, do not explain the differences in post-transition medical care expenditures between MFP participants and those who transition without the benefit of the MFP program. The likelihood of using these services after transition was not significantly different between MFP participants and other transitioners with similar characteristics.