Georgetown U. Releases Report on Fla. Medicaid Managed Long-Term Care Program

Georgetown University’s Health Policy Institute and six Florida organizations released a report Dec. 11, 2013 on the state’s new Medicaid Managed Long-Term Care program, which has been implemented in six regions of the state and will be fully operational statewide by March 1, 2014.

The mandatory transition of large numbers of consumers who use long-term care services – the elderly and adults with disabilities – from fee-for-service to managed care is unprecedented.

The report, which draws on interviews with stakeholders across the state, found:

• Despite considerable planning and a phased program launch, many details were unclear as operations began and observers were uncertain about whether key program goals would be achieved.
• More than one-third of enrollees failed to choose managed care organizations initially, suggesting that more aggressive outreach and counseling efforts are needed.
• The recruitment of case managers and other staff from community-based organizations to managed care plans posed challenges for local organizations and consumers who rely on them.

“The transition to a managed care system has the potential to improve service quality and decrease costs, but more upfront investment and lead time are needed to achieve the ambitious goals Florida has set for its new program,” said Laura Summer, a senior research scholar at the Georgetown University institute who studies Medicaid long-term care programs across the country and authored the report.

The report identified another major hurdle for Medicaid long-term care consumers when Florida’s statewide mandatory managed care program for medical services goes into effect later in 2014, adding complexity to coverage decisions. Most consumers will have to navigate separate long-term and medical care systems and could be enrolled in multiple plans.

“This development will make the program goal of delivering coordinated, person-centered services very difficult to achieve,” said Summer. “Outstanding questions about the impact that Medicaid managed care will have on the long-term care population underscore the need for ongoing monitoring on the part of all stakeholders.”

The group also released a tool kit to help stakeholders monitor program activity and outcomes.

The brief and tool kit are made possible through the support of a coalition of Florida-based funders including the Winter Park Health Foundation, AARP Florida, Alleghany Franciscan Ministries, the Health Foundation of South Florida, the Jessie Ball duPont Fund, and the Quantum Foundation.