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1 Money Follows the Person Modeling Tool

2 V 3.4
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4 Prepared by the Rutgers/NASHP Community Living Exchange
5 Robert Mollica, NASHP and Leslie Hendrickson, Hendrickson Consulting
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8 Box 1: Purpose - This spreadsheet can be used to determine the impact of nursing home transitions in states that have a provider tax. It also estimates the impact of the enhanced
9 federal reimbursement available under the Money Follows the Person Demonstration.
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11 What to enter: To use the modeling tool, enter the data identified in Box 2.
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13 Box 2: Assumptions - enter figures for your state for the variables below
14 1. Enter per diem NF rate $125.00
15 2. Enter beneficiary paid amount per diem for institutional services $10.00
16 3. Enter FMAP (federal reimbursement rate) for services 57%
17 4. Enter NF provider tax rate 6.0%
18 5. Enter monthly cost of other state plan services (institutional consumers) $100
19 6. Enter monthly cost of other state plan services (community consumers) $100
20 7. Enter average annual per person HCBS cost $20,000
21 8. Enter MFP additional annual administrative costs $250,000
22 9. Enter number of individuals who transition per year $200
23 10. Enter FMAP for administrative costs 50%
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25 Box 3: Medicaid costs in an institution State Impact State Impact Federal Impact Federal Impact
26 Without Provider With Provider Without Provider With Provider
27 Tax Tax Tax Tax
28 Matching rate (share of cost) 43% 43% 57% 57%
29 Annualized NF payment (Assumption 1 minus Assumption 2, times 365) $41,975 $44,494 $41,975 44,494
30 Other Medicaid state plan services (Assumption 5) $1,200 $1,200 $1,200 $1,200
31 Total cost $43,175 $45,694 $43,175 $45,694
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33 Share of institutional costs $18,049 $18,049 $23,926 $25,361
34 Impact of provider tax NA $(1,436) NA
35 Share of other state plan service costs $516 $516 $684 $684
36 Net cost (annual) $18,565 $17,130 $24,610 $26,045
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39 Box 4: Medicaid costs in the community State Impact State Impact Federal Impact Federal Impact
40 Regular FMAP MFP Enhanced FMAP Regular FMAP MFP Enhanced FMAP
41 Matching rate (share of cost) 43% 21.5% 57% 78.5%
42 Average annual cost per person (Assumption 7) $20,000 $20,000 $20,000 $20,000
43 Added administrative costs NA $1,250 NA 1250
44 Other Medicaid state plan services (Assumption 6) $1,200 $1,200 $1,200 $1,200
45 Total cost per person $21,200 $22,450 $21,200 $22,450
46 Net cost of HCBS per person (annual) $9,116 $5,441 $12,084 17,009
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49 Box 5: Differences/savings with Regular FMAP State Impact State Impact Federal Impact Federal Impact
50 Without provider tax With provider tax Without provider tax With provider tax
51 Net cost for NF $18,565 $17,130 $24,610 $26,045
52 Net cost for HCBS per person $9,116 $5,441 $12,084 $17,009
53 Difference (annual) $9,449 $11,689 $12,526 $9,036
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55 Differences/savings with MFP enhanced FMAP State Impact State Impact Federal Impact Federal Impact
56 Without provider tax With provider tax Without provider tax With provider tax
57 Net cost for NF $18,565 $17,130 $24,610 $26,045
58 Net cost for HCBS per person $5,441 $5,441 17,009 17,009
59 Difference (annual) $13,124 $11,689 $7,601 $9,036
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61 Box 6: Aggregate annual differences with regular FMAP State Impact State Impact Federal Impact Federal Impact
62 Without provider tax With provider tax Without provider tax With provider tax
63 Number of participants 200 200 200 200
64 Net cost for NF $3,713,050 $3,425,941 $4,921,950 $5,209,059
65 Net cost for HCBS annual $1,823,200 $1,088,200 $2,416,800 $2,416,800
66 Difference $1,889,850 $2,337,741 $2,505,150 $2,792,259
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68 Aggregate annual differences with MFP enhanced FMAP State Impact State Impact Federal Impact Federal Impact
69 Without provider tax With provider tax Without provider tax With provider tax
70 Number of participants 200 200 200 200
71 Net cost for NF $3,713,050 $3,425,941 $4,921,950 $5,209,059
72 Net cost for HCBS annual $1,088,200 $1,088,200 3,401,800 3,401,800
73 Difference $2,624,850 $2,337,741 $1,520,150 $1,807,259
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75 Note: Impact of provider tax - The annual net state cost for nursing home care is reduced by the amount of federal
76 reimbursement received on the revenue generated by the provider tax.