National Council on Medicaid Home Care Holds LTSS Panel Discussion
April 25, 2014 03:46 PM
NAHC’s affiliated National Council on Medicaid Home Care held a panel discussion during the March on Washington entitled, “Medicaid Managed Long Term Services and Supports: This is the Future!” Michelle Martin, the Council’s Director of Policy, moderated. The session featured the following speakers:
Sherl Brand, Chief External Affairs Officer & VP/Business Development, VNA Health Group
Christopher Palmieri, President VNS of New York
Michael Brown, BAYADA Home Health Care
Richard Fredrickson, Sr. VP, Long Term Care, Centene Corporation
Topics of discussion included: the overall transition of the long term services and supports (LTSS) population into managed care; the use of technology in managed LTSS; the importance of providers and plans communicating and educating each other; concerns regarding credentialing and claims submission; and discussion of what plans think determines “quality providers.”
While addressing concerns, all panelists stressed the importance of cooperation between plans and providers in transitioning to manage care. “We believe in managed care for the LTSS population because we believe that it hits the goals of the Triple Aim: Access, Quality, and Lower Costs,” said Mr. Palmieri. “With managed care, you can continue to have a relationship beneficial to consumers, providers, and plans.” Mr. Fredrickson commented: “We see further penetration of managed care into the Medicaid space. With that, we need providers and payers to come together more effectively on the part of the consumer. This is especially relevant in the LTSS space, because of the complex needs of the consumers and their co-morbid conditions in particular.”
Mr. Brown agreed. “This session is uniquely important,” he stated. “It allows providers and plans to join together in the best interest for clients in this important transition.”
Mrs. Brand stated: “If we’re going to see successful rollouts of MLTSS, there has to be communication and collaborations between providers, plans and their states. Otherwise, all parties will encounter obstacle after obstacle.”
The transition to Medicaid managed care has been filled with challenges and opportunities for providers. Home care providers should be aware that beneficiaries and interest groups alike are voicing legitimate concerns regarding the move to managed care in Medicaid. Providers are also not powerless or voiceless in the matter.
Stakeholders can be very useful in improving a state’s transition to managed care in Medicaid. Likewise, if these stakeholders have outright opposition to using managed care in Medicaid, the forums are there to voice those opinions. Home care providers are encouraged to keep abreast of managed care transitions in their states, advocate on a state level, and to contact the Council with any questions or concerns.
To learn more about the LTSS panel, and to read the Council’s related issue brief that focuses on topics ranging from managed care transitions to technology, credentialing and claims submissions to quality, please click here.