Caring for New Yorkers Through Partnerships with Managed Long Term Care Plans

By Emma DeVito | April 2, 2024

As lawmakers in Albany weigh various ways to control spending and improve the quality of health care in the Empire State, one of the most important items on their plate is the future of the state’s Managed Long Term Care (MLTC) program. Roughly 288,000 elderly, disabled and other vulnerable New Yorkers rely on an MLTC health plan to access the care they need to live healthier, independent lives. Lawmakers have an obligation to these individuals and their loved ones to preserve and protect this vital program.

The Senate and Assembly took an important first step this week by rejecting an ill-advised proposal to eliminate the MLTC program in their proposed budget bills. Consensus has emerged that proposed legislation to dismantle MLTC health plans and replace them with a “fee-for-service” model is misguided. Lawmakers also made the right decision in rejecting a proposal that would require the already-strapped state Department of Health to competitively bid the MLTC program.

While the budget bills proposed by both houses mark a positive step in the direction of preserving and protecting the MLTC program, the state shouldn’t lose focus on striving to better serve and meet the needs of New Yorkers served by it. Lawmakers should shift their attention to leveraging health plans as key partners in this work.

With a long history of delivering person-centered services, expertise in managing and coordinating care, and trusting relationships with their 280,000 members, MLTC plans are well-positioned to help the state make tweaks that will improve the program without creating major disruptions for those who receive care.

The first solution lawmakers should focus on is restoring the $111 million in Medicaid Quality Incentive Program (QIP) funding that that was stripped out of the executive budget proposal. This funding stream helps expand much-needed access to care for low-income New Yorkers and people of color. Both Houses took an important step by including this funding in their respective budget bills and should ensure that the final budget includes this restoration.

Next, policymakers should make members who qualify for both Medicaid and Medicare (often referred to as “dual-eligible” enrollees) a top priority. Dual-eligible enrollees are some of the state’s most vulnerable people, yet they often experience inefficient care, lacking care coordination between their Medicaid and Medicare health benefits, and worse outcomes than those enrolled in just one of the programs.

Fortunately, we know that integrated care—when people are enrolled in one health plan for both their Medicaid and Medicare coverage—works. Integrated plans can improve care outcomes, enhance member satisfaction and reduce costs. Today, only a small portion of all dual-eligible New Yorkers are enrolled in an integrated plan.

There are many steps the state can take to increase the number of dual-eligible enrollees who receive more integrated care. In fact, the state already has a roadmap outlining these steps, many of which can be accomplished relatively quickly. Managed care organizations like ours are eager to support the state in making this roadmap a reality.

Funding the QIP and advancing integrated care for dual-eligible enrollees are important steps to improving the care, experience and outcomes for some of our most vulnerable New Yorkers. In order to do this, we need a strong and stable MLTC program, including the health plans that are experts in keeping members with long term care needs healthy and safe in the community.

With just weeks until the state budget deadline, there is not much time left to get this right. MLTC plans are committed to collaborating with the state to continue to meet the needs of the enrollees we serve, not cast unnecessary uncertainty over their health care.

Emma DeVito is the President and Chief Executive Officer of VillageCare. She also serves as the chair of the NYS Coalition of Managed Long Term Care Plans, comprised of Medicaid Managed Long Term Care (MLTC) plans that specialize in providing community-based long term care services and supports across the state to nearly 160,000 Medicaid members who are older adults or have disabilities.

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