Nursing home care is a hot topic these days as an increasing number of the “baby boomer” generation require additional assistance. However, nursing home care is expensive, running roughly $6,000 per month, and many residents may do better at home – with a little bit of extra help.
Some states are transitioning nursing home patients into Medicaid in-home managed care programs that are generally less expensive, allow patients to live quasi-independently and avoid issues of nursing home abuse and neglect. Florida is leading the way in this transition – and everyone is watching.
How the Transition Process Works
According to Kaiser Health News, there’s been a shift in Florida to enroll those on Medicaid, the state-federal health insurance program for the poor, who need long-term care, into privately run managed care plans.
Although there has been a general shift to transition Medicaid recipients into managed care over the past 20 years, that effort has been mostly limited to women and children. Since August of 2013, Florida has mandated the same approach for 45,000 nursing home residents and another 40,000 who get long-term care services at home or in assisted living facilities.
Here’s how the transition process currently works: Florida pays seven managed care plans a preset monthly fee to cover the costs of each resident that allows state officials to predict – and limit – annual Medicaid costs. Florida believes that mandated managed care will save the state money by helping people get support to remain in their homes or in less-costly community settings, rather than in nursing homes, where monthly fees average $6,000.
To make the transition easier for nursing homes, the state legislature guaranteed that health plans could not cut reimbursements in the first year. The state has also required that all nursing homes have the option to be included in all health plan networks in the first year so residents would not have to move to a different facility based on their choice of a plan.
Several other states are considering switching to Florida’s model. In fact, seven other states – Kansas, Delaware, Minnesota, Tennessee, Hawaii, New Mexico and Arizona – also have statewide mandates requiring nursing home residents and other long-term care patients on Medicaid to be in such plans.
Other states, including New Jersey, Ohio, California and Virginia, are planning to do the same later this year and New York, Texas and Rhode Island are expanding the approach to additional counties – although not statewide.
Concerns & Hopes
Many have voiced concerns that insurance companies will be incentivized to hold back benefits and increase their profits. Some consumer advocates and nursing home operators are also worried, especially since Medicaid pays the bills for nearly two thirds of nursing home residents nationwide. Proponents say they hope the plan can potentially save money and reduce the number of nursing home and elder abuse incidents.
Nursing home abuse and neglect is a tragedy and many of our nation’s elderly population don’t have family or friends to make sure they are being treated properly. Sadly, many elderly patients are simply too frightened to stand up for themselves. If you have been the victim of personal injury related to nursing home abuse, contact an experienced Florida nursing home abuse attorney to discuss your situation, find an alternative and determine if you might be entitled to compensation for your injuries.
Nursing home care is a hot topic these days as an increasing number of the “baby boomer” generation require additional assistance. However, nursing home care is expensive, running roughly $6,000 per month, and many residents may do better at home – with a little bit of extra help.
Some states are transitioning nursing home patients into Medicaid in-home managed care programs that are generally less expensive, allow patients to live quasi-independently and avoid issues of nursing home abuse and neglect. Florida is leading the way in this transition – and everyone is watching.
How the Transition Process Works
According to Kaiser Health News, there’s been a shift in Florida to enroll those on Medicaid, the state-federal health insurance program for the poor, who need long-term care, into privately run managed care plans.
Although there has been a general shift to transition Medicaid recipients into managed care over the past 20 years, that effort has been mostly limited to women and children. Since August of 2013, Florida has mandated the same approach for 45,000 nursing home residents and another 40,000 who get long-term care services at home or in assisted living facilities.
Here’s how the transition process currently works: Florida pays seven managed care plans a preset monthly fee to cover the costs of each resident that allows state officials to predict – and limit – annual Medicaid costs. Florida believes that mandated managed care will save the state money by helping people get support to remain in their homes or in less-costly community settings, rather than in nursing homes, where monthly fees average $6,000.
To make the transition easier for nursing homes, the state legislature guaranteed that health plans could not cut reimbursements in the first year. The state has also required that all nursing homes have the option to be included in all health plan networks in the first year so residents would not have to move to a different facility based on their choice of a plan.
Several other states are considering switching to Florida’s model. In fact, seven other states – Kansas, Delaware, Minnesota, Tennessee, Hawaii, New Mexico and Arizona – also have statewide mandates requiring nursing home residents and other long-term care patients on Medicaid to be in such plans.
Other states, including New Jersey, Ohio, California and Virginia, are planning to do the same later this year and New York, Texas and Rhode Island are expanding the approach to additional counties – although not statewide.
Concerns & Hopes
Many have voiced concerns that insurance companies will be incentivized to hold back benefits and increase their profits. Some consumer advocates and nursing home operators are also worried, especially since Medicaid pays the bills for nearly two thirds of nursing home residents nationwide. Proponents say they hope the plan can potentially save money and reduce the number of nursing home and elder abuse incidents.
Nursing home abuse and neglect is a tragedy and many of our nation’s elderly population don’t have family or friends to make sure they are being treated properly. Sadly, many elderly patients are simply too frightened to stand up for themselves. If you have been the victim of personal injury related to nursing home abuse, contact an experienced Florida nursing home abuse attorney to discuss your situation, find an alternative and determine if you might be entitled to compensation for your injuries.