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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.

By Swogger Bruce & Millar, Jan 31 2018 02:08PM

Medicare does not provide indefinite coverage for long-term care. Medicare coverage is only for rehabilitation and can be ended when a patient stops making progress. In any case, Medicare coverage is limited to 100 days. So, the survey findings that nearly 40% of Americans expect to rely on Medicare are troubling.

Nearly 80% of Americans would prefer to receive care in their home, and nearly 70% of their children would like their parents to receive care in their home. There are few government benefits that will help pay for in-home care. The Michigan MI Choice Waiver program can help pay for in-home care, but the coverage is limited by funding issues. PACE programs also attempt to keep people in their homes. However, the program is not widespread. The good news is that PACE will be opening in Northern Michigan in 2019. Veterans pensions, known as aid and attendance or housebound, are the last significant source of government payments for in-home care. All these programs have asset and income limitations.

Despite the limited government benefits, 33% of older Americans have not made any plans to cover care. 72% of Americans support family leave programs to care for a loved one, and the majority support policies to help finance long-term care.

We suggest consulting an elder law attorney and financial professional to learn about your planning options and potential benefits. The link to the full report is provided below.

AP-NORC Poll

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