Plan would move Medicaid long-term care into managed care

Michigan is slowly moving forward on a plan to place its $2.8 billion Medicaid nursing home and long-term care services programs under the management of private health plans, Crain’s has learned.

The Medicaid managed long-term care proposal is similar to controversial 2016 budget language that would move the $2.7 billion quasi-public behavioral health system under health plan control over the next several years. Pilot projects are under development this year to test whether integration of mental and physical health saves money, increases services while maintaining quality and access.

In a tersely worded proposal in the 2017-2018 state budget, Section 1857 states: “By July 1 of (2018), the department (Health and Human Services) shall explore the implementation of a managed care long-term support service.”

Dom Pallone, director of the Michigan Association of Health Plans, took credit for the language in the current year’s budget.

“We asked for it,” Pallone said. “We didn’t ask for this language. We asked for much more detail. Legislators compromised in the process, and the House and Senate agreed with the generalized approach, to evaluate using managed care in the long-term care system.”

Pallone said MAHP wanted pilot program studies, language that they be linked to geographic regions already in place in Michigan and an implementation timetable.

“We were agnostic to how (the funding would flow), but it could be through existing Medicaid contracts, integrated care organization contracts or totally new contracts,” Pallone said.

At least 22 states are exploring ways to integrate long-term care services into their Medicaid programs to reduce costs, increase services and improve quality, according to a 40-page report completed for the state by the Center for Healthcare Research and Transformation in Ann Arbor.

CHRT studied the issue under a contract awarded it last summer from the Michigan Department of Health and Human Services.

The CHRT report found that some states also have begun to integrate long-term care with behavioral health and physical health with Medicaid funding, said Marianne Udow-Phillips, CHRT’s executive director.

– Crain’s

Read the full article here.