Nursing home association wants no part of Medicaid managed care

Managed care is not being warmly embraced by long-term care providers everywhere. Nearly 40 states are in various completion phases of transitioning to privatized Medicaid managed care systems, but Louisiana's nursing homes are defiantly resisting efforts there to have them join the party.

Some observers say the resistance is kinking the process aimed at attracting private companies to bid for the state's business, currently valued at $2.1 billion. About 72,000 state residents, many of whom are developmentally disabled and elderly, are currently enrolled in the Medicaid program. At stake is the final component of Gov. Bobby Jindal's plan to privatize the program. His administration already has private concerns under contract to handle the medical and behavioral health components of the state's $8 billion Medicaid program, according to The Advocate.

The Louisiana Nursing Home Association wants its members excluded from the system and is lobbying the Legislature to do so. The head of the group has declined comment, according to a local media report. LNHA spokeswoman Karen Miller, however, questioned whether “reslicing the long-term care pie” would be helpful since the current “nursing facility program is economical and efficient.”

Meanwhile, the Louisiana chapter of AARP generally favors people transitioning to home- and community-based settings if it's suitable and less expensive. AARP and other patients advocates are preparing to heavily lobby the state Legislature, claiming the nursing home industry's move could lead to serious splintering issues in care delivery and coverage.

“If nursing homes are able to carve themselves out, it's going to fragment healthcare opportunities for everyone and reduce choices for seniors,” AARP Louisiana director of advocacy Andrew Muhl told The Advocate. “It will likely result in longer wait times for people who want to live independently in their homes.”

An American Health Care Association report calls the growth of managed care in dealing with older adults a "risky business.” The association asserts that states have limited experience in managed long-term services and supports.