INDIANAPOLIS — The Indiana Family and Social Services Administration (FSSA) is launching its new PathWays for Aging program. There are more than 123,000 eligible Hoosiers aged 60 and older.
PathWays for Aging is a Medicaid managed care program, like the Healthy Indiana Plan, Hoosier Healthwise and Hoosier Care Connect.
That means that instead of paying for individual claims, Indiana will pay managed care organizations (MCOs) a flat fee per member. On PathWays, individuals will contact a care coordinator to find services and resources to meet their healthcare needs.
“Before PathWays, the aging individuals on Medicaid had to navigate a complicated healthcare and supports system on their own,” FSSA Secretary Dr. Dan Rusyniak told 13News' partners at the Indiana Capital Chronicle. “Now, individuals need only one point of contact for assistance, making it easier for more Hoosiers to stay in their homes, surrounded by family and friends.”
Indiana already spends more than 43% of its Medicaid spending on managed care organizations, according to KFF. Lawmakers are pushing FSSA to provide more transparency on how that money is being spent. The federal Health Department is also increasing scrutiny of the programs nationally.
Changes coming to Medicaid waivers
On July 1, Indiana also phased out the Aged and Disabled Waiver for Medicaid. That is the waiver that lets providers deliver services in a patient's home or community, instead of at a long-term care facility like a nursing home.
There will now be two kinds of waivers: the PathWays Waiver for patients aged 60 and older, and the Health and Wellness Waiver is for everyone aged 59 and under.
Per federal approvals, there are a set number of slots available for each:
- PathWays for Aging Waiver: 39,842 slots, of which 29,268 are filled by Hoosiers already receiving services. 10,574 slots will remain for newly eligible individuals.
- Health and Wellness Waiver: 16,127 slots, of which 13,190 are filled by Hoosiers already receiving services. 2,937 slots will remain for newly eligible individuals.
The Arc of Indiana is concerned that FSSA is not planning to fill all available PathWays and Health and Wellness (H&W) Medicaid Waiver slots. By comparing available slots to FSSA's stated enrollment schedule, it appears 975 available PathWays slots and 1,437 H&W slots won't be filled.
"The failure to fill all available slots means people who need and qualify for services now for the H&W Waiver will face a 30 month wait and people who need and qualify for services now for the PathWays Waiver face an 11 month wait," said Arc director of communications Sally Morris. "At the same time, people will continue to be added to waiting lists."
Each slot can only be used by one person for the next year. That means if a patient no longer needs care, their slot is still used and can't be taken by someone who does.
To learn more about the program, or apply, click this link to the state's website.
You can also get more information and assistance from the advocates at The Arc of Indiana.
