Partnership Between VNS Health and Elderwood Health Plan Aims to Bolster Local Managed Long-Term Care in Western New York

Rhea-AI Summary

VNS Health partners with Elderwood Health Plan to transfer members to VNS Health's MLTC plan, ensuring a seamless transition and continued care for homebound older adults and people with disabilities in Western New York. The partnership aligns with NYS Budget provisions for MLTCs to offer D-SNP plans, prioritizing integrated benefits for Medicaid members with Medicare. VNS Health will automatically enroll Elderwood members into their MLTC plan if they do not choose another plan within 60 days.

Insights

Healthcare Policy Analyst

The consolidation of Managed Long-Term Care plans (MLTCs) within New York State, as seen in the agreement between VNS Health and Elderwood Health Plan, reflects a broader trend in the healthcare industry towards integration and alignment with state policies. The NYS Budget's requirement for MLTCs to have a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) with a certain quality rating is indicative of the state's commitment to improving care coordination for dual-eligible populations—those who qualify for both Medicare and Medicaid.

This partnership is likely to streamline operations and reduce administrative costs for both entities, potentially improving profitability. By ensuring a seamless transition for members and providers, VNS Health could enhance its reputation and member satisfaction, which are critical factors in the competitive MLTC market. However, the consolidation also raises concerns about market competition and the potential for reduced consumer choice.

Healthcare Financial Analyst

From a financial perspective, the agreement between VNS Health and Elderwood could impact the revenue streams and cost structures of both organizations. The transfer of approximately 1,200 members to VNS Health's MLTC plan could result in increased scale and bargaining power with healthcare providers, possibly leading to more favorable contract terms. Nonetheless, the costs associated with integrating Elderwood's members and coordinating with the newly formed IPA must be weighed against the anticipated revenue growth.

Investors and stakeholders should closely monitor the approval process by the New York State Department of Health, as it will determine the final go-ahead for the transaction. The financial implications of the partnership will become clearer once the transition is underway and the operational efficiencies or challenges emerge.

Healthcare Management Analyst

The formation of an Independent Practice Association (IPA) as part of the partnership is a strategic move that allows Elderwood to retain a role in managing care for its former members while leveraging VNS Health's infrastructure. The IPA model facilitates local provider relations and delegated care management, which can lead to improved care outcomes and patient satisfaction. For VNS Health, the local presence and expertise of Elderwood in Western New York could be instrumental in maintaining high-quality care and member retention.

However, the transition of members and integration of services will require meticulous management to avoid disruptions. The success of such partnerships hinges on the effective alignment of organizational cultures, systems and processes. The management teams of both VNS Health and Elderwood will need to work collaboratively to navigate the complexities of merging their MLTC operations.

NEW YORK, Feb. 21, 2024 /PRNewswire/ -- VNS Health, which operates the largest nonprofit managed long-term care plan (MLTC) in New York State, has entered into an agreement with Elderwood Health Plan (Elderwood) to enroll members of Elderwood's MLTC Plan into VNS Health's MLTC, pending New York State Department of Health (NYSE: DOH) approval.

Under this new partnering agreement, Elderwood will continue to play a key role in the care of homebound older adults and people with disabilities in Western New York. Through a recently formed Independent Practice Association (IPA), Elderwood would manage the care of its former members who enroll in the VNS Health MLTC, along with any new and existing VNS Health members who reside in Erie, Genesee, Monroe, Niagara, Orleans and Wyoming counties. The IPA will include delegated care management, local provider relations, and certain administrative functions.  Although Elderwood Health Plan is slated to cease its operations as an MLTC as of May 1, 2024, the IPA ensures a seamless transition for Elderwood members, staff, and providers.

The VNS Health–Elderwood partnership is in keeping with provisions enacted in the 2023-2024 New York State (NYS) Budget that require all MLTCs to have a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP), with 3 or more stars.

Integrated benefits for Medicaid members who have Medicare is a priority for the NYS Department of Health this year. With approval by NYS DOH, the partnership will allow MLTC members from Elderwood to transfer to VNS Health, or to choose another MLTC plan in the area.

According to the agreement between the two organizations, VNS Health's MLTC plan will automatically take on any of the approximately 1,200 members now enrolled in Elderwood Health Plan who do not elect to join another MLTC plan in the area following the 60-day window after notification of the transition by NYS DOH.

"VNS Health and Elderwood are committed to ensuring this transition is a smooth one, with no disruption or change in care for any Elderwood members moving over to VNS Health's MLTC," notes Dan Savitt, President and CEO of VNS Health. "We're honored that Elderwood has entrusted its plan members to us, and we are committed to working closely with the new Elderwood IPA to provide outstanding integrated MLTC benefits and services."

"Elderwood is excited to find a partnership in VNS Health and believe this will benefit our members. VNS Health understands the importance of our Western New York community and keeping a local presence through Elderwood. We share the same values of putting our members, community, and employees first, and are excited to pursue this new opportunity." – Dr. Jeffrey Rubin, Co-Owner and Co-President of Elderwood Health Plan

About VNS Health:
VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us—we help people live, age, and heal where they feel most comfortable, in their own homes, connected to their family and community. VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of those we serve in New York City, Westchester, Long Island and parts of Upstate New York.

View original content to download multimedia:https://www.prnewswire.com/news-releases/partnership-between-vns-health-and-elderwood-health-plan-aims-to-bolster-local-managed-long-term-care-in-western-new-york-302066846.html

SOURCE VNS Health

FAQ

What is the partnership between VNS Health and Elderwood Health Plan about?

The partnership involves transferring members of Elderwood's MLTC Plan to VNS Health's MLTC plan in Western New York.

What are the benefits of the partnership for Elderwood members?

Elderwood members will experience a seamless transition to VNS Health's MLTC plan with continued care and integrated benefits.

What does the agreement between VNS Health and Elderwood entail?

The agreement states that VNS Health will automatically enroll Elderwood members into their MLTC plan if they do not choose another plan within 60 days.

Why is the partnership in line with NYS Budget provisions?

The partnership aligns with the NYS Budget requirements for MLTCs to offer D-SNP plans, focusing on integrated benefits for Medicaid members with Medicare.

Who is responsible for managing the care of Elderwood members in the VNS Health MLTC plan?

Elderwood will manage the care of its former members in the VNS Health MLTC plan through the newly formed Independent Practice Association (IPA).