Managed care under fire in Massachusetts
More than 100 advocacy groups for seniors and those with disabilities have called on Massachusetts officials to establish protections for those in long-term care.
In a letter to Massachusetts Gov. Charlie Baker (R), the groups cited concerns with efforts to cut costs by including a model for managed care in MassHealth, which administers Medicaid. A managed care model would unite a patient's complete health services under a single group of providers.
That model, advocates say, wouldn't take into account long-term care patients' needs. In their letter to officials, the advocates said providers may reduce care in order to cut costs, or only refer patients within a provider's network.
“Checks and balances” should include an independent advocate for each long-term care patient, the letter stated. The advocate would determine a patient's long-term care needs, create a personalized plan of care and ensure the patient didn't receive any unnecessary care.
"This letter says if you're going to put all the Medicare and Medicaid money in the hands of big provider groups, we want there to be on that team an independent agent who represents the consumer and is guided by what the consumer wants rather than by a network of providers," Al Norman, executive director at Mass Home Care, told MassLive.
The letter was signed by representatives from providers, advocacy groups and local councils on aging.