Future Directions for Home Community-Based C.PPTVIP

Future Directions for Home Community-Based Care Services Carol Raphael President CEO, Visiting Nurse Service of New York Alliance for Health Reform Long-term Services and Supports: A Rebalancing Act October 3, 2011 * Who We Are: Founded in 1893 by Lillian D. Wald, VNSNY is the largest non-profit home health care agency in the U.S. Serves all five boroughs of NYC, plus Westchester and Nassau Counties Structure is twofold: 1) Provider System and 2) Health Plan Provides a range of services to an average daily census of 31,000 patients, from newborns to seniors 15,000 employees – most are field staff providing direct care Serves a socio-economically diverse population (36% speak a foreign language) The “Henry Street Family” (c. 1900) Visiting nurses in a row (date unknown) The Visiting Nurse Service of New York * VNSNY Provides Care Acrossthe Continuum of Needs + Mental Health VNSNY’s Continuum of Care Post-acute Long-term End of Life ** Goal is to enable people to move across continuum as needed and to avoid institutional care and remain as independent and high-functioning as possible ** * Profile of a Typical VNSNY Patient… Post-Acute Care VNS CHOICE Cases 101,142 10,284 Median Age 74 years 82 years Preferred Language 75% English, 18% Spanish, 7% Other 38% English, 38% Spanish, 11% Chinese, 12% Other Avg # diagnoses 3-4 3-4 Top diagnoses Diabetes, nervous/ musculoskeletal, hypertension, heart failure Diabetes, Heart Disease, Chronic Obstructive Pulmonary Disease, Hypertension Median LOS 28 days 53 months * VNSNY CHOICE Health PlansManaged Care Plans for High-Cost Chronically Ill Dual-Eligibles 1,600 MLTC members are virtually enrolled in both Medicaid MLTC MA SNP High-Touch Care Management Model Aims Reduce Hospitalizations Readmissions Integrate sites and settings Delay institutionalization Medicaid Managed Long Term Care (MLTC) Medicare Advantage (Special Needs Plan and Part D) Year End ‘10 Census 9,337 members 6,692 members Benefits and Services Provide