Big changes in long-term care

Big changes in long-term care

The Obama administration last week gave Gov. Rick Scott one of the two waivers he’s requested for managing Medicaid, the federal-state health program for the very poor. The waiver affects long-term care for 87,000 low-income seniors and disabled people who now receive nursinghome or in-home care under Medicaid.

Given that Medicaid consumes about $21 billion of the state’s $74 billion budget — and that long-term care accounts for about 18 percent of Medicaid’s budget — we all have a stake in the efficient management of the program’s long-term care services for our most frail citizens.

Gov. Scott is certain that by contracting with a limited number of private companies, Florida can deliver better services at a lower cost. Now, he’s got the chance to prove it.

If nursing home patients, or those trying to stay out of nursing homes, get into a plan that offers more meaningful coordination of care, they will be better off for this waiver. For it gives the state more flexibility in providing alternatives to nursing home care, such as attendant care, adult day care, homemaker and respite services, transportation, and much more.

But if frail seniors and disabled people are placed with a provider who doesn’t sweat the details of caring for individual needs, they could be worse off.

It’s like our health-care system as a whole, where there’s good and bad players, and unless you’re an insider, finding a quality provider is largely a matter of luck.

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