Federal regulations are finally catching up with a decade of seismic change in the delivery of Medicaid services. More than 650 pages of proposed new rules are aimed at overseeing managed care, which has become the standard health care delivery system for low-income adults and children, and is now being expanded to include both medical care and long-term supports and [...]
What if they gave a managed care plan and nobody came? That seems to be the problem with California’s ambitious effort to enroll more than 400,000 low-income seniors and younger people with disabilities into a fully-integrated care program that covers both medical treatment and long-term supports and services. The idea has enormous promise, but relatively few Californians seem willing to [...]
California has taken the idea of managed care for low-income seniors and people with disabilities to a whole new level. Under an agreement with the Obama Administration announced last week, the state will begin shifting both medical care and long-term supports and services to managed care companies in just seven months. Watch this closely. You may be looking at the [...]
In 2012, about 13 million seniors participated in Medicare Advantage (MA) managed care plans—about 27 percent of the Medicare population and twice as many as were enrolled just seven years ago. This rapid shift to managed care by seniors may be just a first step towards a fundamental change in the way Medicare is delivered and financed. And it has the [...]
Medicaid is in the budget bull’s eye. But many lawmakers aiming to cut the program have no idea what it does, and how important it is to frail seniors who need help with daily living. The popular image of Medicaid: health care for a poor mother and her children. The all-too-common reality: long-term supports and services for an 85-year old [...]
Insurance giant Wellpoint is the latest carrier making a big bet on managing care for those seniors and adults with disabilities who are eligible for both Medicare and Medicaid. About 9 million people, called “dual eligibles” receive benefits from both programs. They are both very poor and very sick and often have significant needs for personal assistance. Medicaid alone spends $145 [...]
Let me tell you about Frank. At 86, he has heart disease, diabetes, and kidney failure. He lives at home but struggles with the 16 medications he must take every day. He could also use some social support--maybe an adult day program, help shopping, or just somebody to keep him company. What Frank needs most of all is somebody who can help organize all of his medical [...]