Medicaid changes cause 'money grab' for low-cost members

In an effort to cut costs, New York's Medicaid program shifted $6 billion in public spending on long-term care to managed care companies; but the changes resulted in a competitive frenzy to enroll people requiring minimal care, including group home residents who could be "brokered in bulk," a New York Times investigation found. People with complex health needs were dropped as organizations and providers "bought, sold or steered cases according to the new system's calculus: The more enrollees and the less spent on services, the more money the companies can keep," The Times reported. Though state officials tout an 87 percent member satisfaction rate with the revamped program, beneficiaries told The Times they were pressured to sign up for long-term care plans under the threat of losing coverage if they refused. Experts say the biggest loophole is a lack of objective assessment of whether enrollees need the services so aggressively marketed to them, The Times reported. Article

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