Becky,
LA has had managed health care for regular Medicaid beneficiaries for several years but people with long term supports and services were carved out. Recently they were able
to opt in but very few have so far. Our state has been planning to move LTSS into managed care for several years. There has been extensive stakeholder involvement but there is still a fear that regardless of how good the design is, the implementation will
not be as good. The plan for MLTSS here is also to fully integrate LTSS, behavioral, acute, and primary health care. If things go according to schedule the RFP will be released in July/August 2015.
Sandee
Sandee Winchell
Executive Director
La. Developmental Disabilities Council
(225) 342-6804
(800) 450-8108 in LA
(225) 405-1433 cell
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From: xxxxxx@nacdd.simplelists.com [mailto:xxxxxx@nacdd.simplelists.com]
On Behalf Of Steve Gieber
Sent: Thursday, March 12, 2015 2:32 PM
To: xxxxxx@nacdd.simplelists.com
Subject: Re: DD Councils RE: Managed Care
This sounds like the Kansas model. The insurance companies lost around $200 million in the first couple of years. The state has since given them more money and were not sure where the savings
is. It is all very hard to track.
From: "Swedeen, Beth - BPDD" <xxxxxx@wisconsin.gov>
Reply-To: <xxxxxx@nacdd.simplelists.com>
Date: Thursday, March 12, 2015 at 11:14 AM
To: "xxxxxx@nacdd.simplelists.com" <xxxxxx@nacdd.simplelists.com>
Subject: DD Councils RE: Managed Care
Hi Becky,
WI developed over a decade a regionalized managed care system that only does LTC for the DD/PD/frail elder populations. We also had a self-directed option (known as IRIS) outside managed care that CMS at the
time said was necessary (couldn’t offer just one choice). That option in 6 years has mushroomed to include nearly 12,000 individuals out of 55,000, and about 40% are folks with DD. Our state only collects NCI data on this population, and our outcomes are
above the national averages. Consumer satisfaction (despite incredibly low capitated rates and no increases for 8 years in personal care) is through the roof. The current managed care/self-direction system was created with about a decade’s input from local
and regional stakeholders, extensive county-based pilots, data collection, and a promise of full entitlement when each county/region moved in (Counties had to agree to enter). I would highly recommend consulting with these two extremely knowledgeable people
who have worked in other states as they moved to managed care and who have the historical knowledge of how WI did it (and perhaps things we should have included): Lynn Breedlove (former P&A director),
xxxxxx@gmail.com; and Jim Canales, former county DD director and one of the managed care org’s CEOs until this past January: Jim Canales <xxxxxx@communitycarecw.org>
Our proposed biennial budget from the Governor would completely dismantle our current program; dissolve the local LTC MCO’s; fold our self-direction “into managed care”, and bring in 2-3 large statewide for-profit
insurance companies to take over LTC, acute, primary, and behavioral health in an “integrated package.”
We are heartbroken….and working non-stop to ensure we preserve our high-quality, person-centered, outcomes-based, locally-grown system (have I mastered all my talking points?)
Beth
From:xxxxxx@nacdd.simplelists.com
[mailto:xxxxxx@nacdd.simplelists.com]
On Behalf Of Harker, Becky
Sent: Thursday, March 12, 2015 8:51 AM
To: xxxxxx@nacdd.simplelists.com
Subject: DD Councils Managed Care
Iowa is jumping in to “Medicaid Modernization” (managed care) We would like to poll the list serve about the experiences of states that have enrolled or are enrolling individuals
who use long term services and supports in managed care. We’re especially curious about states that might be seeing positive outcomes for those individuals as a result of the change. We’re certainly hearing the bad and ugly but we’d like to hear if there
are positive results as well. Thank you. Becky
Becky Maddy Harker
Executive Director
Iowa Developmental Disabilities Council
700 2nd Ave., #101
Des Moines, IA 50309
515-288-0442