The Olmstead memo changed the conversation, not the evidence

While the Department of Justice’s (DOJ) June memo reinterpreting Olmstead v. L.C. signals a shift in federal enforcement priorities, it doesn’t alter the research base guiding states’ Medicaid decisions on home and community-based services (HCBS), the authors argue. Mathematica research shows average 2023 Medicaid expenditures were far higher for institutional care (54,462peruser)thanHCBS(17,298), and Money Follows the Person (MFP) Demonstration evaluations found per-person costs dropped roughly 23% in the first year after transitioning from institutions to the community. A 2014 MFP evaluation also found 92% of participants who moved to the community said they liked where they lived, a 32-percentage-point increase from their time in institutional care. The authors note every state now offers HCBS through Medicaid authorities including 1915(c), 1915(i), 1915(k), and 1115 demonstrations.

https://www.mathematica.org/blogs/the-olmstead-memo-changed-the-conversation-not-the-evidence