“There were different players from around the state,” said Rebecca Leahy, executive director of North Country Home Services.
“They wanted to have all Medicaid recipients by 2016 be covered under managed-care companies. What it means, different companies like Fidelis Care and United Healthcare provide Medicaid managed care. They look at a client and determine what care is needed, and they are referred to agencies that provide those services,” she said.
North Country Home Services’ rates per hour are set by the state.
“The Medicaid Redesign Team cut rates across the board by 2 percent,” Leahy said. “They decided that and went retroactive to the beginning of 2011. Two percent of Medicaid moneys paid to us or other agencies had to be paid back.”
This Medicaid recoupment was the difference between the initial rate paid and the cuts, plus interest.
“For North Country Home Services, an estimate over the last year and a half, our portion was $750,000,” Leahy said. “They recouped $750,000. We haven’t seen any increase in our Medicaid rates since 2009.”
Over the intervening years, the agency has had increased costs in doing business, payroll and mileage.
“We were very concerned this year,” Leahy said. “These cuts were negatively impacting our balance and our ability to pay our aides and meet our expenditures.”
The need for care, whether managed or not, will only increase, Pounds said.
“We’re seeing an increase in those authorizations coming into our agency and an increase in clients coming into the waiver programs.
“Due to managed care taking over traditional Medicaid, we have seen an increase in the Traumatic-Brain Injury Medicaid Waiver Program and Nursing Home Transition and Diversion Waiver Program,” Pounds said.
“We want to continue to provide the quality of service they deserve to our elderly and disabled population, but it’s continuing to get more difficult with continued budget cuts to health care.”
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