The center’s goal is to be a one-stop shop of tools, resources, and education members need to succeed in managed care, integrated services, and other alternative payment models. Resources will address both Medicare Advantage (MA) and Medicaid Managed Long-Term Services and Supports (MLTSS) as well as other integrated services and alternative payment models.

Recognizing that more than a third of Medicare beneficiaries are now in Medicare Advantage, with much higher penetration rates in many parts of the country, it’s highly unlikely our healthcare systems will ever return to an entirely fee for service model. In states that use Medicaid MLTSS – right now 41 programs operate in 24 states, with rapidly trending growth (As recently as 2012, there were only 19 programs in 16 states.) LeadingAge members – and the people they serve -- have everything to gain by carving out a positive, pro-active role in these new systems.

We want to help our members both address their immediate concerns, as well as enable them to understand and participate in new program and financing models that integrate primary, acute care, post-acute care, and long-term services and supports.

The Center for Managed Care Solutions & Innovation will offer a variety of resources for all members at various points in their managed care journeys including:

  • Materials to understand the basics about on MA, Special Needs Plans, and Medicaid MLTSS
  • A detailed glossary of managed care terms and acronyms
  • Fact sheets and issue briefs on a variety of different topics related to managed care
  • Webinars and other offerings in the LeadingAge Learning Hub. Early offerings will include both basic understanding of contracting with a managed care plan, how Medicaid MLTSS programs work as well as more advanced issues such as the considerations of becoming a provider-led Special Needs Plan.
  • Summaries of important articles published by researchers, noting what’s relevant for our members

The Center’s content will offer resources for all members because even though Medicare benefits have been focused on hospitals, physicians and post-acute care, its reach via Medicare Advantage plans, as of 2019 and beyond, has begun to touch home and community-based service providers.  Additionally, managed care and integrated service solutions and models are increasingly focused on addressing the social determinants of health for older adults seeking partners to help address food insecurity (e.g., meals on wheels, grocery delivery), safe and affordable housing and transportation barriers.   Therefore, all members must understand how these models work and what their value proposition is within these models to be successful and embrace the opportunities presented.

The Center for Managed Care Solutions & Innovations serves another critical purpose: It is the launching pad for our advocacy work. What we learn and discover from you and others along the way will help inform our policy positions as we advocate for your interests before Congress and the president. In turn, we’ll continue to provide regular and timely updates to members about current policy developments.

The Center for Managed Care Solutions & Innovations will be led by Nicole Fallon, vice president of health policy and integrated services. Please contact us with questions and comments.