TennCare wants home-based care for more seniors

By Tom Wilemon The Tennessean
Change could save Tennessee millions
A change that Tennessee made to its Medicaid program two years ago that helps families care for elderly and disabled relatives has proved so successful that the state is making it available to more people.
TennCare wants to expand the number of slots. Between 11,000 and 15,000 TennCare beneficiaries could be receiving care outside of a nursing home after July 1 — significantly more than the currently approved range of 8,500 to 11,000. Families who sign up get coverage for wheelchair ramps, adult day care, home visits from personal attendants and other assistance.
The expansion of the program is expected to save the state money. Home-based care costs about $19,000 a year on average compared with the $55,000 yearly expense of a skilled nursing facility.Besides saving money, the voluntary program has been embraced by families.“Statewide, we have moved from 17 percent of people receiving home-based care to 31 percent of our people receiving home-based care,” said Patti Killingsworth, an assistant commissioner of TennCare.
The state has notified the Centers for Medicare and Medicaid Services of the expansion plans, which require approval from that federal agency.
“We have every expectation that they will approve this,” Killingsworth said. “They are very supportive of states’ efforts for home and community-based services and to rebalance the system. We absolutely believe that approval will be forthcoming.”

Millions saved

The plans call for increasing the upper limit for enrollees by 1,500 this fiscal year, which ends June 30 — a move that would save TennCare, the state’s Medicaid plan, up to $2.28 million.
Raising the upper limit by another 2,500 the following year, which begins July 1, is anticipated to save $4.05 million.
“We need to make this change in order to continue to afford people choice,” Killingsworth said. “That’s really the name of the program, Choices.”
The yearly cap for the home-based and other services is the cost of a year’s stay in a nursing home.
This program is open only to people eligible for Medicaid who are older than 65 or are disabled and require the level of assistance provided by a nursing home. Current TennCare enrollees can learn more about the program by calling the number for the managed care organization printed on the back of their insurance card.
People who are not on TennCare but think they may qualify for the program can call 1-866-836-6678 or reach their local Area Agency on Aging and Disability.
The General Assembly created the incentives for home-based care in 2008 with the approval of the Long-Term Community Choices Act. CMS signed off on the plan the following year, and Tennessee rolled it out in 2010.
Before the change, TennCare spent 98 percent of its long-term-care funds on institutional care. The state had only a limited number of waivers for families to get coverage for the expenses of home-based care or in a community setting, such as an adult day care.
Contact Tom Wilemon at twilemon@tennessean.com or 615-726-5961, or follow him on Twitter @TomWilemon.