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Managed long-term care: care integration through care coordination
Holly Michaels Fisher1, Terrie G Raphael
1Visiting Nurse Service of New York, USA.
Journal of Aging and Health
|March 5, 2003
Summary
New York's managed long-term care program integrates diverse services for frail seniors. This case study shows VNS CHOICE achieves coordinated care for elderly New York City residents without integrated financing.
Area of Science:
- Gerontology
- Health Services Research
- Public Health Policy
Background:
- Frail elderly populations require comprehensive long-term care solutions.
- Traditional models often fragment services, impacting care quality and efficiency.
- Managed care models offer potential for integrated service delivery.
Purpose of the Study:
- To describe the operational model of VNS CHOICE, a managed long-term care plan.
- To analyze the care coordination strategies employed by VNS CHOICE.
- To evaluate the effectiveness of integrated care delivery without integrated financing.
Main Methods:
- Case study methodology focusing on VNS CHOICE.
- Analysis of program structure, service delivery, and care management.
- Examination of the capitated Medicaid long-term care benefit model.
Main Results:
- VNS CHOICE successfully coordinates a broad range of covered and noncovered services.
- The capitated benefit provides flexibility for care management staff.
- Member and family involvement in care planning is actively supported.
- Integrated care was achieved despite the absence of integrated financing.
Conclusions:
- Managed long-term care programs can effectively integrate services for the elderly.
- Broad care coordination responsibility is key to achieving integrated care.
- The VNS CHOICE model demonstrates a viable approach to long-term care for frail seniors.