Medicaid is constantly reviewing and updating its policies, but many beneficiaries find that it is comparatively rare for Medicaid to update its policies in a way that is truly beneficial to them. Often, “updates” simply make things more complicated. A few recent changes, however, empower beneficiaries to remain at home, or in the community, rather than acquiescing to institutional care. In effect, these changes signal greater awareness of, and respect for, the "aging in place" philosophy.
These regulations require, in many instances, state adoption and implementation to be meaningful. Seniors, their families and caregivers should know, however, that even then, implementation and utilization of these benefits will require awareness, diligence, and persistence to realize. Like Medicare benefits for home care, one could expect that health care providers and other professionals will for some time be generally unaware of the availability of these benefits, and specifically incapable of meaningfully implementing the expanded benefits.
Regardless, there are now additional weapons in the arsenal for those fighting to keep themselves or loved ones free from unnecessary long-term institutional care.
Only California, Maryland, Montana, Oregon, and Texas have approved Community First Choice Amendments to the State Plans.
Expansion of Home and Community Based Services Plan
Previously, the Home and Community-Based Services (HCBS) plan was only offered through waiver programs. The most recent updates to Medicaid, however, provide home and community-based services as part of the regular plan. This means that individuals who qualify for Medicaid can receive either in-home services that will make it possible for them to remain at home longer or community-based services that are much more comfortable than skilled nursing homes as part of their regular care routine.
Community First Choice (CFC) Plan
The "Community First Choice Option" (CFC) allows States to provide home and community-based attendant services and supports to eligible Medicaid enrollees under their State Plan. The CFC state plan gives enhanced federal funding to help provide support and services to individuals who would otherwise require institutional care. These services are designed to provide necessary support to individuals who, without it, would find themselves in high-care level institutions. Providing other elements of care in place of institutional settings is beneficial to both the patient and the program, as it allows them to maintain their quality of life longer and permits the provider to save money in the process.
Money Follows the Person (MFP)
The MFP program is designed to assist individuals who are no longer in need of the services provided within institutions. These funds help them to transition back to their community and independent living when institutional care is no longer required. In many cases, a lack of funding kept people in institutions long past the time when they could have returned home with the benefit of proper care, so this provision has truly been designed with the quality of patient care in mind.
Community Based Long-term Services and Support (LTSS) Funding
Community-based LTSS care allows many individuals to maintain a higher quality of life and enjoy interaction with other individuals in their situation. The new provisions have increased funding for states that help increase access to these programs, encouraging a shift toward community-based services instead of institutional care in many states.
These provisions will be of great benefit to many aging individuals, particularly those with chronic health conditions who wish to remain in their homes for as long as possible. As their need for care increases, they’ll be able to access the services that they need instead of either accepting care that they don’t want in the form of an institutional setting or putting off care that they need because they can’t afford it. These changes to Medicaid policy will likely be the first of many as it becomes necessary to make changes in order to sustain the program.
Care Coordination and Case Management Benefits
The demands of a chronic condition can be overwhelming. For many elderly individuals, it’s impossible to simply list all of the medications they take, much less keep up with the tests and procedures that they’ve undergone. Care coordination and case management ensures that everyone who is treating a given patient is on the same page and that the patient is receiving quality care for all of their conditions, not just the one covered by a specific doctor at a specific moment.
While improvement in care coordination and case management is not specifically related to only home or community based care, the improvement reduces risks often associated with home based care heavily reliant upon the beneficiary or caregivers to coordinate and manage care, and therefore, only encourage home or community based care.
No comments:
Post a Comment