Eliminating MLTC plans would slash quality care

As lawmakers gathered in Albany to hear Gov. Hochul give her annual State of the State speech and propose a state budget, storm clouds were gathering here in Riverdale — and not just the kind that brought the most recent snowstorms.

Some lawmakers proposed a misguided bill that would threaten care for nearly 280,000 people with disabilities and older residents who need full-time care to live independently, or as independently as possible, and can no longer perform everyday activities on their own. This includes more than 17,000 people in Riverdale and across the city and Westchester County who are served by my organization. 

As a person who sees firsthand how important Managed Long-Term Care (MLTC) Plans are for the people and families we serve, I know how important it is for lawmakers to reject this irresponsible and misguided proposal to replace MLTC plans with a managed fee-for-service model. 

MLTC plans make it possible for tens of thousands of New Yorkers with chronic illness, disabilities or advanced age to live healthy and independent lives. Only a MLTC plan has the flexibility in care planning to regularly come up with innovative solutions to individuals’ issues that are tailored specifically to their circumstances.   

Beyond the routine medical care, our people have coordinated meetings with bodega staff to control a member’s diabetes, used a yoga instructor to help teach a member and her daughter how to treat aides respectfully, and provided robotic pets to help calm anxieties and counter isolation. 

Replacing MLTC plans with a fee-for-service model would eliminate this personalized approach, severing the longstanding relationships that MLTC members have with their dedicated team of professionals who, in many cases, have become like family members — all while reducing quality of care and increase taxpayer costs.  

Dismantling these care teams is simply bad policy, particularly given the high member satisfaction with the program and its results. 

We know this because we have been down this road before.  

The state had a fee-for-service model before the current system was introduced a decade ago. At that time, spending on community-based long-term care was unsustainable before the transition to the more cost-efficient, higher-quality MLTC program. In fact, had that model continued, the state would be spending an estimated $1.3 billion more in 2024 than it will under the current program. 

Lawmakers have an obligation to preserve and protect this program using fact-based evidence — not replace it using assumptions based on shoddy math and dubious claims of cost savings by special interest groups. 

After all, you can’t argue with facts: The existing program has resulted in a cost-effective system that has improved the quality of care for patients. Additionally, we have over a decade of data that demonstrates how MLTC plans have improved the health, wellbeing, and independence of the state’s most vulnerable New Yorkers. In 2021, for instance, nearly 90 percent of enrollees rated their MLTC plan as good/excellent. 

We all want what is best for New Yorkers. Pushing misleading statistics doesn’t help plan members or workers. In fact, it hurts the entire system.  

Patient satisfaction and optimal health outcomes need to be driving the agenda in Albany, and we are committed to ensuring that care options for New Yorkers who are older or have disabilities are not disrupted by irresponsible reforms or budget cuts. 

Lawmakers should reject this flawed proposal and instead collaborate with MLTC providers to improve the program and continue to meet the needs of the beneficiaries we serve, not cast unnecessary fear and uncertainty over their health care — and their lives. 

The author is executive vice president of RiverSpring Health Plans, a managed long term care plan that serves populations in Westchester County, New York City and Long Island. and a member of the New York State Coalition of MLTC Plans.