Balancing Incentive Program (BIP) Work Plan Released

The Department of Health (DOH) was awarded the Balancing Incentive Program (BIP) grant in March 2013. As LeadingAge New York has previously reported, BIP provides a financial incentive for states to enhance non-institutionally based long term services and supports. As part of the BIP programmatic terms and conditions, DOH had to submit a final work plan within six months from the date of the initial application. The BIP work plan had to include the current status of the systems and milestones and deliverables to measure the state's progress towards the goal of non-institutionally based long term services and supports. Also included in the work plan are the amounts of project funds to be earned through participation in BIP, and how they will be used towards the three structural changes required by the statue: No Wrong Door/Single Point of Entry System, conflict-free case mangement and a core standarized assessment instrument.   

Included in the posted the BIP work plan are details on the three structural changes broken down into 13 objectives. LeadingAge New York has been closely following the ninth objective, Conflict-free Case Management (CFCM). There are three places in the work plan that outlines CFCM: page 32-35, C.1- 11 and E.1-8. There are several areas in the CFCM objective to note:

• As the state transitions many programs to managed care, it is likely that there could be potential areas of conflict of interests.
• "NYS is expected to eliminate some potential conflcits of interest that may arise in a managed care environment by separating the initial asessmment of eligibility for long term services and supports from the assessment and care planning process."
• "To further address the conflict between assessment and care planning process, NYS plans to hire a dedicated resource with expertise in organizational structures and segregation of duties to develop options for resolutions..."
• "NYS plans to review the work plans and strategies of other managed care states for other ideas... as the transition to Care Management for all."

Please note on C.1-8 that the state intends to mitigate conflict in managed care plans by monitoring through the surveillance process of beneficiary satisfaction and the beneficiary complaint system.  

LeadingAge New York had previously submitted comments on CFCM to DOH in August 2013.

In addition, the BIP work plan outlines the expansion of the UAS-NY (E.1-8 and E.1-27).

In section E.1-15, an area that is still pending, includes creating a pool in which managed care plans and FIDA can compete to receive a temporary rate enhancement. A portion of these funds would be earmarked for managed care entities serving individuals across the disability spectrum.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871