Exec: Medicaid managed LTC may be harder than you think

Today, the state has mandatory managed LTC only for home care.

The state is hoping increased use of care management for nursing home residents will lead to better care coordination, lower rates of institutional use and increased consumer satisfaction, but the mandatory Medicaid managed LTC enrollees may be much different from other Medicaid enrollees and from the original volunary managed LTC program enrollees, Clyne said.

New York state does not have enough nursing home beds today, many nursing homes are financially vulnerable, and Medicaid premiums cover only half of the cost of keeping an enrollee in a nursing home for a month, Clyne said.

The state also has to work on expanding the supply of apartments that provide some services for seniors, Clyne said.

“The best managed care service available is useless if the individual does not have a  safe,  affordable  place to live,” Clye said.”While congregate senior housing is an ideal location for low-income seniors to  remain independent and receive supportive services, there is a severe and growing shortage of  this much needed resource, especially in downstate communities. In addition, much of the  current infrastructure needs rehabilitation.”

The state also needs to make it easier for managed care providers to work with assisted living facilities, Clyne said.

See also:

• Kaiser finds more Medicaid managed LTC
• Nursing home firm to help manage Illinois Medicaid care
• LTCI Watch: Dr. Frankencoordinator