Palo Alto, CA (Law Firm Newswire) May 16, 2013 – The state of California is planning to shift long-term care to managed care companies.
Managed care companies offer comprehensive care for low-income seniors and people with disabilities for a fixed monthly rate. The program to be adopted in California is MediConnect and it is designed to cover individuals with extensive levels of care and is covered by benefits from both Medi-Cal, California’s version of the federal Medicaid program, and Medicare.
“During the next 12-plus months, it is estimated that approximately 456,000 people will be enrolled in California in the largest program of its kind,” noted Palo Alto elder law attorney Michael Gilfix.
In Los Angeles alone, as many as 200,000 people will be enrolled, a larger one-state group than anywhere else in the U.S.
Advocates of managed care support comprehensive care for people with disabilities and the elderly. The complexities of their needs are typically better met in a full-package program, one which uses nutrition, supervision, transportation, and activities fully designed to cover all aspects of care needs. Managed care can mean huge savings; a one-service system typically costs significantly less than hiring out one-task specialists for every service. California advocates of managed care currently estimate that while the program will save just one percent in the first year, it will see savings closer to four percent by year three. Under Medicare, any medical costs which are reduced under a long-term care program go back to the federal government. Under the new program, savings would revert to the state.
But managed care critics are concerned: this wave of complex managed care patients in Los Angeles is the first of its kind. Can high-quality care for so many people with a multitude of complex issues be met consistently? If the program cannot produce a profit, how and where will they cut back? And how will that affect the quality and range of services?
As this is implemented, the need for asset protection and long-term care planning will be greater than ever.
The California program is being launched as a three-year demonstration. Other states, including Illinois, Ohio, Massachusetts, and Washington, who are beginning to run similar managed care programs, will be watching closely to see how well it works for the state, and for the patients.
To learn more, visit Gilfix & La Poll Associates LLP at http://www.gilfix.com/.
Gilfix & La Poll Associates LLP
2300 Geng Rd., Suite 200
Palo Alto, CA 94303
Telephone: (650) 493-8070
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