Home- and Community-Based Long-Term Care in New York's Medicaid Program: New Data on Service Use and Spending

Author/Editor: Sarah Samis


See the related press release.

New York State is implementing Medicaid reforms to move complex and costly Medicaid beneficiaries—long-term care services and supports, behavioral health care, and services for the developmentally disabled—from fee-for-service into managed care. The first of these large-scale policies, known as mandatory MLTC, requires frail elderly and physically disabled Medicaid beneficiaries who rely on home- or community-based long-term care services (HCBS) to join a managed care plan. New York began implementing this policy in 2012.

This data brief documents the shift of Medicaid HCBS from fee-for service into managed care between 2010 and 2013. It presents regional differences in services and spending, and evaluates the growth in Medicaid managed long-term care and the corresponding decline in fee-for-service HCBS, particularly in personal care use, reflecting an explicit policy goal of New York.

Download this report below. Also, read an accompanying issue brief, Mandatory Managed Long-Term Care in New York's Medicaid Program: Key Eligibility and Enrollment Issues, which analyzes the enrollment and eligibility related to this policy change.

Update: On May 2, 2014, one sentence and an accompanying footnote on page 6 were edited to clarify how much New York’s Medicaid program spends annually on long-term care services for the frail elderly and physically disabled.

Copyright: 2014
Published: 03.31.2014




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