BIP at a Glance

The Balancing Incentive Program, authorized by Section 10202 of the 2010 Affordable Care Act (ACA), aims to improve access to community-based long-term services and supports (LTSS). Through September 30, 2015, participating states received enhanced Federal Medical Assistance Percentage (FMAP) on eligible services. States that spent less than half of their total LTSS dollars on community LTSS in 2009 received 2% enhanced FMAP; states that spent less than 25% received 5% enhanced FMAP. As part of the Program, participating states are required to:

  •          Undertake structural changes, including the No Wrong Door (NWD) system, a Core Standardized Assessment (CSA), and conflict-free case management
  •          Spend Program funds to enhance community LTSS
  •          Meet the “balancing benchmark,” i.e., spend a certain percentage of total LTSS dollars on community LTSS (25% or 50% depending on the 2009 starting point)