2017 Managed Long Term Care Quality Report Released

The Department of Health (DOH) released its annual Managed Long Term Care (MLTC) Report last month. The report contains demographic, social, and functional status information about the enrollees of each plan and presents plan performance on measures related to quality, member satisfaction, and potentially avoidable hospitalizations. Performance on these measures, in addition to some compliance measures, determines whether a plan will receive a payment from the MLTC Quality Incentive Pool and the amount of the payment.

The MLTC Report presents plan performance in the following domains:

• Current Plan Performance on Quality of Life, Effectiveness of Care, and Emergency Room Visits
• Access and Experience of Care
• Functioning and Activities of Daily Living
• Quality of Life and Effectiveness of Care Over Time
• Potentially Avoidable Hospitalizations
• Satisfaction with the Experience of Care

Many of the measures presented in the report have been selected for use in Medicaid value-based payment (VBP) arrangements, such as Potentially Avoidable Hospitalizations (PAH) for heart failure, respiratory infection, electrolyte imbalance, sepsis, anemia, or urinary tract infection. The results reflected in the report are based primarily on data collected from MLTC members through the Uniform Assessment System (UAS) and, for purposes of the PAH measure, hospital discharge data collected through the Statewide Planning and Research Cooperative System (SPARCS).

Highlights of the report include:

• Ninety-five percent of enrollees had no falls that resulted in medical intervention in the past 90 days.
• Eighty-seven percent of enrollees remained stable or demonstrated improvement in the activities of daily living function.
• Seventy-seven percent of enrollees remained stable or demonstrated improvement in urinary continence.
• The statewide rate of PAH was 3.57 PAH per 10,000 days enrolled in a plan. 
• Eighty-seven percent of respondents rated their MLTC plan as good or excellent.
• Eighty-three percent rated the helpfulness of the plan in managing their illnesses as good or excellent.

The MLTC Report was accompanied by the release of the 2017 MLTC Regional Consumer Guides, which assign star ratings to MLTC plans in various domains.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383 ext. 124