title: Managed long-term care: care integration through care coordination.
abstract: The New York State managed long-term care demonstration program combines traditional home, community, and institutional long-term care services with other benefits integral to maximizing overall well-being for a frail elderly population. A distinguishing feature of the model is the responsibility to coordinate both covered and noncovered services. This article, a case study of VNS CHOICE, a managed long-term care plan that serves 2,500 New York City residents, describes the program's operating structure, service delivery model, and care management strategies. By providing a capitated Medicaid long-term care benefit, VNS CHOICE can utilize a broad array of services, offer significant flexibility to care management staff, and support member and family involvement in care planning. Its broad care coordination responsibility allows it to achieve integrated care without integrated financing.
authors.affiliation: Visiting Nurse Service of New York, USA.
authors.forename: Holly Michaels
authors.initials: HM
authors.lastname: Fisher
authors.forename: Terrie G
authors.initials: TG
authors.lastname: Raphael
mesh_terms: D000368:Aged; D016330:Frail Elderly; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D008134:Long-Term Care / Q000458:organization & administration*; D008329:Managed Care Programs / Q000458:organization & administration*; D009518:New York; D010346:Patient Care Management / Q000458:organization & administration*; D010347:Patient Care Planning; D010865:Pilot Projects