Embarking on a journey can spark curiosity and fuel a sense of hope. At the start of something new, I feel a mix of emotions as I anticipate what lies ahead, but I enjoy looking forward with excitement at the prospect of new experiences.
The state of Indiana has been on a journey of reshaping long-term services and supports for older adults. Thanks to the contributions and input of many stakeholders, this journey has culminated in a collection of interconnected paths across the “Crossroads of America,” each telling a unique story of collaboration and a shared commitment to the well-being of our treasured older adults.
This new initiative from Indiana Family and Social Services Administration, called PathWays for Aging, is set to launch on July 1, 2024. Hoosiers aged 60 and over who receive Medicaid (or Medicaid and Medicare) benefits on the Aged & Disabled waiver will transition to this new program to manage benefits and coordinate care services.
Transition to Managed Care for A&D Waiver Members
Medicaid, as a public assistance program funded by taxpayer resources, requires careful consideration to ensure its sustainability. The current fee-for-service model in Indiana has its challenges, particularly as beneficiary totals and needs continue to rise in alignment with an expanding older population. PathWays for Aging represents a shift towards a managed long-term services and supports program (mLTSS), with three experienced health plans carefully selected to drive success.
More than 30 states have already moved to mLTSS. What sets Indiana’s program apart is its integrated care approach, bringing together the social care long-term services and supports of the Medicaid Aged & Disabled waiver and the healthcare coordination of insurance benefits such as Medicare.
Cost-Effective Community-Based Services
At least three out of four older adults want to age in place in their own homes and communities where they feel safe, secure and comfortable. But is this affordable and cost-effective? It turns out it is. Receiving home- and community-based services, such as those managed by CICOA’s Flourish Care Management team, helps to reduce costs. PathWays aims to deliver person-centered care that helps aging Hoosiers get the services and support they need to live independently.
While we focus on the benefits of home- and community-based care through PathWays, it is crucial to acknowledge the value of institutional care settings and short- and long-term care in senior living communities. These are excellent options, and CICOA proudly collaborates with many such organizations. PathWays health plans aim to ensure individuals receive the necessary support in settings that align with their needs.
This forward-thinking approach reflects a commitment to sustainability and improved outcomes. By transitioning from a fee-for-service model to a managed care model focused on health outcomes, Indiana is taking a proactive stance towards ensuring the sustainability of Medicaid services well into the future. This will allow Indiana to better invest in quality care for older Hoosiers.
Overview of PathWays for Aging
PathWays for Aging will provide improved coordination of care across multiple insurances, such as Medicaid and Medicare, so Hoosiers can live life their way. It is a thoughtfully designed solution featuring seamless coordination that makes accessing and navigating benefits easier. It ensures that all older Hoosiers have access to quality care and can achieve similar health outcomes regardless of race, ethnicity, geography, etc. The integration of social care services, such as transportation, home repairs, nutrition and case management, with clinical healthcare services, is a groundbreaking approach.
Collaborative efforts, including input from stakeholders like myself and other Area Agency on Aging executives, have provided input to FSSA, which helped them to design a cutting-edge program with our treasured older Hoosiers’ stories at the heart of it.
Benefits of PathWays for Aging
The transition to managed care not only improves coordination but also provides a better value proposition for both the state and beneficiaries. With resources and opportunities to offer additional services that may not be accessible under the current system, the health plans may be able to offer enhanced benefits, such as caregiver support, that can help care recipients and their families. Plus, for beneficiaries under both Medicare and Medicaid, they will experience more seamless care coordination and consistency.
Change can be unsettling, especially when it comes to healthcare. Recognizing this, PathWays for Aging prioritizes the continuity of care for existing agencies and beneficiaries. In the first 90 days of the program, there will be no adjustments made to any service plans, ensuring a smooth transition and setting the stage for improved health outcomes for individuals and the community.
Rollout and Enrollment Timeline
What is the timeline for the launch of PathWays?
- Feb. 2024 – Individuals who are age 60 and above and currently receiving Medicaid benefits will begin receiving letters from Indiana Family and Social Services Administration this month.
- This letter will notify you of the available health plans through Anthem, Humana and UnitedHealthcare.
- Members will need to select and enroll in a health plan through Maximus, the enrollment broker.
- June 2024 – Members will receive a welcome packet from their chosen plan.
- July 1, 2024 – Health coverage with PathWays for Aging plan begins.
During this enrollment phase, we encourage you to call the PathWays helpline with any questions and to select a health plan:
PathWays is a thoughtful, stakeholder-informed initiative that promises a more integrated, consistent and compassionate experience for beneficiaries. Let us all stay informed, engaged, and supportive as we navigate this exciting journey together, ensuring a brighter and healthier future for Indiana’s older adults.
For more information, including comprehensive FAQs for members and providers and a comparison of the health plans, visit in.gov/pathways.
As President and CEO, Tauhric Brown uses his strategic vision and experience in the elderly and disability service industry to expand CICOA services and collaborative partnerships to better meet the needs of the vulnerable populations we serve. Before joining CICOA, Brown served as the chief operating officer for Senior Services, Inc. in Kalamazoo, Mich. His career started in the U.S. Army, and then he became a successful owner/operator for a multi-carrier wireless retail company. Inspired by his family and upbringing, he made the switch to the nonprofit world to fulfill his dream of improving the lives of others.