Providers cry foul at Vermont plan to shift care to community

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Nursing home providers are concerned about a new five-year Medicaid demonstration project in Vermont that aims to redirect nursing home residents into home- and community-based care options. The "Choices for Care" project began on Saturday.

Providers, as well as representatives of the Vermont Health Care Association, foresee a 500-bed drop during the next five years.

The Centers for Medicare & Medicaid Services recently granted the state's Department of Aging and Independent Living a waiver allowing the Medicaid program to expand its long-term-care coverage to home health and other services.

The state hired 12 clinical care coordinators for the project. The will conduct needs assessments for people requiring long-term care services -- with an eye toward non-nursing home placements. People now in nursing homes will also be evaluated, to determine where they should receive care.

In a related development, Vermont became the first state in the nation to accept a five-year cap on federal Medicaid funds. In exchange, the state will receive unprecedented flexibility for managing people on Medicaid and controlling program costs.