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Michigan Considering Letting HMO's Manage Its Medicaid Long-Term Care Program

By Swogger Bruce & Millar, Feb 19 2018 10:47PM

Michigan is exploring the radical idea of letter private HMO's administer its $2.8 billion long-term care program. The initial review of the idea is expected in July. Part of Michigan's justification is valid; Medicaid is fragmented into different programs administered by different entities. The main programs are nursing home long-term care, MI Choice Waiver for in-home care and assisted living, and PACE which strives to keep seniors in their home.

A consolidation of all the programs would be a good idea, letting private insurance companies control the care and funds is not a good recipe for improving the care of vulnerable Michigan seniors. The Michigan Association of Health Plans is lobbying hard to grab these funds. It is unlikely the health plans will prioritize care over profit.

The Area Agency on Aging Association of Michigan has issued strong statements against the plan. Area Agencies on Aging currently administer the MI Choice Waiver and PACE programs. The Health Care Association of Michigan, which represents state nursing homes, has issued statements indicating it is skeptical of the proposal; it feels Michigan does a good job of administration and profit-driven entities will not improve the administration or services.

The proposal has not garnered much attention, unlike the previous plan to privatize Michigan's mental health system. That proposal met with heavy resistance, but Michigan has managed to authorize a few pilot programs.

Any switch of Medicaid funds to private insurance should be scrutinized closely, and improving care should always be the focus, not profit.

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