PHCA/CALM Urges Administration to Move Methodically When Implementing MLTSS

HARRISBURG — The Pennsylvania Health Care Association/Center for Assisted Living Management (PHCA/CALM) today offered to work closely with the Wolf Administration and the entire General Assembly to ensure that managed long-term care will not reduce access to care, will, in fact, improve care, and will save the state money before proceeding with statewide expansion.

“More than 25 states have implemented some form of managed care under Medicaid for individuals requiring long-term services and supports,” said PHCA/CALM CEO Stuart H. Shapiro, M.D. “Each states system of Managed Long-Term Services and Supports (MLTSS) is very different and has had varying degrees of success in assuring access to care, saving money and managing the long-term care population.”

“Pennsylvania should proceed carefully, and test various MLTSS models, to determine whether care improvements and savings can be expected before expanding the program statewide,” Dr. Shapiro added. “We need to develop Pennsylvania-specific data that show the elderly and disability communities are not hurt by MLTSS and that any program the state implements will actually save the state money before dismantling the current system we have.”

The Pennsylvania Long-Term Care Commission (LTCC), on which Dr. Shapiro served, recommended that the state develop and implement MLTSS as a demonstration project initially.

“The Commission report endorsed not proceeding unless the commonwealth demonstrates that positive health outcomes for consumers and savings can be achieved. Pennsylvania should consider options that include both Medicaid and Medicare dollars, as the major cost saver really is reduced hospitalizations paid by Medicare,” Dr. Shapiro said.

“We look forward to working with the administration and the legislature to ensure that any expansion of MLTSS is phased in to assure that it improves care and outcomes for consumers, and continues to focus our tax dollars towards care for vulnerable Pennsylvanians rather than the bottom line of large multi-state insurance companies,” he said. “We should all share the same goal, which is real objective data that will prove that Pennsylvania’s plans are person-centered and cost-effective, and that consumer care is protected.”