States in which only 25% of spending is for community-based services (75% or more of spending goes toward institutional services) will receive a 5% increase in FMAP and states that spend 50% on community-based services (and 50% on institutional services) will receive 2% increase in their FMAP. States must create a single point of entry, conflict-free case management services, and a standardized assessment instrument in order to be eligible for grants.
The Centers for Medicare and Medicaid Services (CMS) sent guidance to states about the State Balancing Incentive Payments Program effective October 1. States can apply for an increased Federal Medical Assistance Percentage (FMAP) payment for diverting people from institutional care by increasing access to community based services and supports. States that rely heavily on institutional services get more FMAP as an incentive to move their systems away from facilities and toward community-based service provision.