Health plans develop person-centered plans of care based on
patient-specific assessments. Plans have matched care to individual
needs, reducing excessive use, improving quality and saving taxpayer
dollars.
The article also suggests that plans target enrollment of healthier
individuals. However, payments are proportional to each member’s level
of care need.
Plans receive higher payments for sicker enrollees and lower payments
for healthier enrollees. This payment method is explicitly intended to
reduce incentives for selective enrollment. Since January 2012, 46,000
people have joined managed long-term care plans. While no system is
perfect, most people have moved smoothly to managed care.
If enrollees disagree with their proposed plan of care, an independent
appeals process protects members. Managed long-term care plans have
improved care management and quality while reducing costs.
PAUL F. MACIELAK
President and Chief Executive
New York Health Plan Association
Albany, May 2, 2013
President and Chief Executive
New York Health Plan Association
Albany, May 2, 2013
To the Editor:
This article and other recent articles offer the public a much-needed
understanding of the problems that arise when a new government program
is rolled out in haste.
Advocates have repeatedly argued that the implementation of New York’s
new Medicaid managed long-term care program is being rushed and have
called for a delay. The shameful stories of greed and deception as
described in your articles point to the imperative for the state to halt
implementation.
State officials must work with advocates and providers to ensure that
thoughtful and transparent operations are in place before the plan is
foisted upon the vulnerable elderly and the disabled who rely upon it
for their health care.
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