The Problem When We Talk About MLTCs

Whenever I hear about MLTCs, I know there will always be one word following the conversation.


What I hear always includes something along the lines of: cutting costs, reducing costs, or reigning in costs. The dollar sign is prevalent in every chat.

Now, of course, costs are a serious concern. Health care costs are rising, and we need solutions that address the public’s right to quality care and affordable care.

And it seems, at first, for those who need it most, MLTCs are the answer. The premise sounds great, the state pays a fixed monthly rate to provide patients health care services. But there’s a catch, this only makes money (saves money) if the care provided is less than the monthly fee. And herein lies the problem. This quickly becomes an incentive to give patients less care than they actually need. As an example, read this story about a patient who went from 24 hours of care to just 4 hours. Thankfully, his repeal prevented the cutback in care hours.

But this also begins to suggest that nursing homes and hospitals are “excessive” care, and while I agree that hospital admissions should be reduced, I don’t agree that patients’ options should be limited. Whether that means fewer hours of at-home care, or less money towards long-term nursing home situations, the incentive to ensure patients are getting what they need over making money doesn’t seem like it’s in focus.

I won’t pretend to have the answers, because I don’t. But the only way we can begin to solve the problem is by starting with patients’ needs first, and working our way back. With more and more states adopting this method, we need to take a step back and look at things from the perspective of those who we’re caring for.

What do you think? How have MLTCs affected your business or family?

link to last blog post (about hospital readmissions)