HCP is urging the Legislature to outright reject this proposal, as it would lead to the closure of many home care businesses in New York, particularly smaller home care providers, and severely limit access to essential and specialized care for consumers.
Lack of Support for Aging Population
New York’s population is aging, with 3.7 million New York residents currently over the age of 60. This number is projected to double in the coming years, increasing demand for home care services on an already stressed industry.
LHCSAs provide essential health care and personal care services to assist with daily tasks and allow vulnerable people to stay in the comfort and safety of their homes. With a reduced number of LHCSAs, there will be reduced access to these services, and thousands of elderly and disabled New York residents will be forced to either go without care or be placed in a more costly setting – which is in direct conflict with the goals of the State’s Medicaid Redesign Initiative.
Questionable Cost Savings
This is included as an administrative proposal, and is not included in Health/Mental Hygiene Article VII language. The State estimates this proposal would produce a savings of $13.71 million for the 2018-19 State fiscal year. At this time, industry stakeholders are unaware of the methodology by which this savings is calculated. Simply put, there is no reasonable justification for the limiting of LHCSA/MLTC contracts to ten.
This proposal would provide additional leverage to MLTC plans over home care providers in negotiations where providers are already severely disadvantaged. Also, at a time when MLTC plans continue to be underfunded, many will be left with little option but to contract with providers offering an unsustainable rate borne by non-compliance with State labor and public health rules and regulations. Moreover, MLTC plans hold the majority of the power during plan/provider negotiations. An MLTC does not have to contract with a particular agency if they choose not to; therefore, there is no need for a restrictive number of contracts.
In addition, this proposal would go into effect October 1, 2018 – leaving little time to shift provider/plan contracts and little time to place the consumer into a different network if necessary. This proposal would be incredibly disruptive to all parties involved.
Limiting Consumer Choice
HCP is supportive of recent proposals regarding VBP and rewarding MLTC plans for improved quality based on provider performance measures. However, by placing an arbitrary statutory cap on the number of LHCSAs an MLTC plan can contract with, elderly and disabled Medicaid enrollees would be forced into a severely limited home care provider network that would significantly restrict consumer choice. This would particularly restrict access to essential care regionally and predominantly in niche markets where smaller providers may thrive.