Navigating Managed Care’s Strange New World
State Medicaid programs have been moving at warp speed to turn over long-term services and supports (LTSS) to managed care companies. For some states, this marks the first journey into the tricky terrain of mandatory managed care for seniors and people with disabilities.
The bad news: No one state has mastered this universe, so other states can’t just follow the leaders.
The good news: We’re releasing a guide, Putting Consumers First: Promising Practices for Medicaid Managed Long-Term Services and Supports, that maps the way forward.
Our guide explains long-term services and supports – the constellation of services that range from nursing home care to community based supports such as personal care, home-making, and transportation. It describes the risks and benefits that can hurt or help consumers with chronic illnesses and disabilities, who depend on LTSS to live with dignity and as much independence as possible. It details policies that promote good care, from planning to enrollment, from financial incentives to care coordination, and performance measurement to consumer ombudsmen. It cites examples of states where these policies are being applied. And it provides tips on how advocates can get involved and who may be allies in shaping better outcomes. Finally, it provides links for those who want to explore further.
If your state is one of the 26 who are on this journey or about to launch, we recommend you beam up this report.
— Alice Dembner, project director