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Old 02-09-2018, 04:11 AM
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Post Will home care suffer if Cuomo's managed long-term care reforms pass?

The financial state of the New York home-care industry is getting worse,
according toa report released Monday by the Home Care Association of New
York State. The industry group said the reforms Gov. Andrew Cuomo is
proposing to the managed long-term care system would only exacerbate the
situation. The average operating margin for certified home health
agencies in New York dipped to -13.46% in 2016 from -7.3% in 2015, the
trade group found. The share of agencies reporting negative margins in
2016 grew to about 78%, up from 70% in 2015. Many home-care agencies
rely heavily on the Medicaid funding they get through managed long-term
care plans. "I would say we're deeply concerned about the budget cuts
and other administrative actions targeting managed long-term care plans,"
said Joanne Cunningham, president of the association. "That will have a
dire effect on the home- and community-based sector's ability to deliver
care to a very needy and frail population." The governor's executive
budget, released last month, includes proposals to cut managed long-term
care plans' administrative budgets, limit the number of home-care
agencies that can participate in a plan's network and raise the
requirements for patients to be eligible for services provided under
managed long-term care plans. Under the proposed changes, patients
would have to get a higher score on their needs assessment in order to
qualify for managed long-term care services. Matthew Hetterich,
director of corporate business development at Utopia Home Care, which is
based in Kings Park, Long Island, and operates in multiple states,
recalled his agency's experience in North Carolina. "In one stroke of the
pen, the state disenrolled a large number of people at one time," he
said. "We had a number of clients who unfortunately stopped receiving
services because of that. Any time you provide services to a certain
number of patients and then all of sudden that number is cut in half, it
will definitely impact you financially." Maria Alvarez, executive
director of the Statewide Senior Action Council, said the higher score
needed to obtain services is "basically unattainable." But Rick
Surpin, president of Independence Care System, an MLTC plan based in the
Bronx, said it makes sense for the state to concentrate its resources on
the neediest patients. "If you don't raise the bar, the program will
just keep on growing and growing. And I don't think that's sustainable,"
said Surpin. His plan serves a disproportionate share of high-cost
beneficiaries, and he said the state underpays for those Medicaid
recipients in order to cover more people. Both Surpin and Hetterich
said it would be unreasonable for the state to limit the number of
licensed home-care agencies in each managed long-term care network to
just 10, a move the executive budget briefing book said would "bring
consolidation to the marketplace." Surpin said he currently has about
140 agencies in his network, and "that's not unusual at all." The
state Health Department defended the proposals, saying the executive
budget "streamlines efficiencies to the managed long-term care program by
targeting quality licensed home care services agency providers, reducing
potential for waste and abuse, and ensuring access to community-based
long-term care services and supports for a growing aging population."
—C.L. Crain’s Health Pulse, February 6, 2018
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