November 30, 2023

Lawmaker flags concerns over Medicaid change, FSSA celebrates maternal health program

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The Family and Social Services Administration Pathways for Aging program will shift long-term care to utilize Managed Care Entities. MCE’s will manage every aspect of care for one fee, rather than providers charging the state for each service individually. - Courtesy of Indiana Family and Social Services Administration

The Family and Social Services Administration Pathways for Aging program will shift long-term care to utilize Managed Care Entities. MCE’s will manage every aspect of care for one fee, rather than providers charging the state for each service individually.

Courtesy of Indiana Family and Social Services Administration

The state is changing how it handles long-term care for Medicaid members 60 years or older through its Pathways for Aging program. One lawmaker is concerned about the program’s rollout.

The Family and Social Services Administration Pathways for Aging program will shift long-term care to utilize managed care entities. MCEs will manage every aspect of care for one fee, rather than providers charging the state for each service individually.

Rep. Ed Clere (R-New Albany) said there’s a disparity between what he’s hearing in committee meetings on the Pathways program and from Area Agencies on Aging.

“I hope it will be successful,” Clere said. “I want it to be successful. I am willing to do anything that I can do to help make it successful, but I'm afraid it's going to be a train wreck.”

FSSA said it has been coordinating with AAAs for the rollout of the program. However, Clere said MCEs are taking over case management, meaning AAAs are losing the revenue which often subsidizes the other functions of the agencies.

The Pathways Program is set to go into effect by July 2024. The state will send notices to Medicaid members to select their MCE beginning in early 2024.

The meeting also included updates on FSSA’s maternal health initiatives.

Indiana has one of the highest rates of maternal mortality in the country, but state officials are highlighting the success of a program meant to address one of the leading causes.

READ MORE: National drug policy experts want to address policy, stigma over perinatal substance use in Indiana

Substance use disorder was the most common contributing factor to maternal mortality, causing 43 percent of all pregnancy-associated deaths in Indiana in 2020. The Indiana Pregnancy Promise program is a free program for Medicaid members who use or have used opioids that connects them to treatment and care.

About 90 percent of participants achieved sustained recovery while enrolled and 82 percent of infants were born at a healthy birth weight with shorter hospital stays, according to the first annual report on the program.

Dr. Maria Finnell, FSSA’s chief medical officer, said she’s thrilled with the program’s progress so far, but she wants more data to see how participants compare to those outside of the program.

“You're volunteering to the program, so it's obviously probably some selection into the program versus not being,” Finnell said. “But we are trying right now to do a comparison with similar women not being in the program and look at outcomes and so forth, because that would be important.”

Finnell also provided updates on other initiatives in the “planning stages,” including updates on how to improve Medicaid reimbursements for doulas and if the state can bill Medicaid for maternal home visiting service.

Abigail is our health reporter. Contact them at aruhman@wboi.org.

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