Managed long term care ( mltc ) is a capitated payment program that provides long term care in both community and residential settings. capitated means that health care professionals, such as physicians and nurses, are paid a set amount for the care of a person that is assigned to them, within a given timeframe. the word capitated may be more fully understood by referring to the phrase per capita which means per head or, for each individual.
Integrated care delivery and care management are included in managed long term care plans, that are plans which are alternatives to medicaid fee-for-service plans.
In new york state, mltc is made possible through the medicaid ny program.
What Is The Background Of MLTC?
Article 44 of the new york public health law was amended by the long-term care integration and financing act of 1997. the amendment was made as a demonstration project for the integration of alternative financing and long-term care service delivery through managed long term care plans.
MLTC Aims To :
1. Prevent or delay the onset of chronic medical conditions
2. Reduce utilization of the health care system, and,
3. Decrease fragmentation of care for the consumer, while simultaneously avoiding the high cost of care in an institutional setting.
Can anyone avail of managed long term care plans ?
Membership or enrollment in a managed long term care plan is not mandatory, but voluntary.
What medicaid does is something known as spreading the risk. that is to say, medicaid pay a fixed monthly amount per member, aware of the fact that there are members who require a lot of medical services, while some members need only a few or minimal medical services.
Are Health Care Providers Adequately Compensated Under MLTC?
Under the mltc, it is immaterial whether care is actually availed of or not by the person assigned to health care providers or medical professionals contracted to mltc.
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