Category Archives: Medicaid

8 states mandate Medicaid recipients be transferred to managed care plans

Should states mandate nursing home and assisted living residents be transferred from Medicaid into managed care plans? I’d prefer to be at home rather than in a nursing home. But I don’t know what the typical living conditions at home look like for Medicaid recipients.

Eight state have mandates requiring nursing home residents, and people receiving long-term care services at home or assisted living facilities, to be transferred from Medicaid (the state-federal health insurance program for the poor) into managed care plans. Seven more are pursuing the approach.

Florida, Kansas, Delaware, Minnesota, Tennessee, Hawaii, New Mexico and Arizona have statewide mandates. New Jersey, Ohio, California, Virginia, New York, Texas and Rhode Island are in the process of similar legislation. As a result, the number of long-term care residents enrolled in mandatory managed care is projected to double this year to 1.2 million.

Florida is betting mandated managed care will save money by helping people get support to remain in their homes or in less costly community settings rather than in nursing homes where fees average $6,000/month. The elderly and disabled account for about 6 percent of Medicaid enrollees but nearly half of the program’s spending.

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