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Support Consumer Choice and Access to High-Quality MLTC!

Managed Long-Term Care (MLTC) plans manage and pay for the long-term care (LTC) services provided to more than 300,000 older adults and people with disabilities eligible for Medicaid in New York. MLTC plans that cover only Medicaid benefits, as well as plans that combine Medicare and Medicaid services (Programs of All-Inclusive Care for the Elderly (PACE) and Medicaid Advantage Plus (MAP)), enable some of the most vulnerable New Yorkers to remain in the community by providing robust care management, arranging a custom-tailored set of LTC services, and supporting post-acute transitions from hospitals and nursing homes to the community. By delivering health care services and supports in the home for individuals who would otherwise require nursing home care, these organizations enhance the quality of life of their members while helping to reduce overall Medicaid costs.

A proposal in the Governor’s budget appears intended to abandon the specialized expertise and commitment of MLTC plans sponsored by non-profit LTC providers in favor of large insurers that focus on non-elderly, non-disabled populations.  The proposal requires the Department of Health to select a limited number of MLTC plans using a competitive procurement process based on criteria, such as the plan’s participation in the Child Health Plus Program or other health insurance programs that do not focus on older adults and individuals with disability.  Most MLTC plans operated by non-profit LTC provers do not participate in these programs and would be at a disadvantage in the procurement.  Moreover, the proposal would limit consumer choice and disrupt established relationships between consumers and providers, and between providers and plans.

Additional troubling proposals would cut approximately $150 million from Medicaid-funded home and community-based services through a 1% cut in MLTC rates, and the elimination of quality incentive funding to MLTC plans -- a $103.6 million cut.  The quality funding supports value-based payment (VBP) initiatives with LTC providers and would disproportionately impact high-quality plans and the high-quality providers that receive the incentives. More details and our 2024 MLTC Budget Brief is available here.

LeadingAge New York is urging legislators to reject these proposals and support consumer choice and access to high-quality MLTC and community-based care.

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Support Consumer Choice and Access to High-Quality MLTC!

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