Centene’s Health Net is rolling back an assisted living transition service for Medi-Cal members, a health plan spokesperson confirmed to Becker’s on Aug. 18.
Through the California Advancing and Innovating Medi-Cal initiative — a multiyear transformation plan for the state’s Medicaid program — Community Supports are optional services to address health-related social needs. For example, some focus on transitional rent for members at risk of homelessness or personal care.
The Assisted Living Facility Transition Community Support aims to bring members at home or in a nursing facility to an assisted living facility, keeping them in a community and preventing institutionalization.
Health Net said it was an “early adopter” of the optional Community Supports but will discontinue this specific service Jan. 1.
“Based on several years of experience and data, our data shows that the Assisted Living Facility Transition Community Support has not led to better care or fulfilled the state’s goal of being a cost-effective alternative to services covered under Medi-Cal, as measured by fewer ER visits and days in the hospital when compared to a control group of similar members who did not use the optional service,” the spokesperson said in a statement.
Health Net said it is working with members, care management teams, providers and the state to establish personalized transition plans, as well as determine eligibility for other programs. Eligible members can still receive the service through their current authorization period.
The insurer did not respond to a question about how many people would be affected, but CalMatters reported Aug. 17 that approximately 3,500 Medi-Cal patients use Health Net to cover assisted living costs. CalViva Health and Community Health Plan of Imperial Valley also contract with Health Net.
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