GREAT NECK, NY – The North Shore-LIJ Health System announced today that its health plan subsidiary, North Shore-LIJ Health Plan, Inc., has been approved by the New York State Department of Health to offer managed long-term care (MLTC) services to Medicaid recipients on Long Island and in Brooklyn, Manhattan, Queens and Staten Island. The approval adds the MLTC plan to the commercial insurance products offered by North Shore-LIJ CareConnect Insurance Company, Inc.
North Shore-LIJ Health Plan’s MLTC is a managed long-term care plan designed for individuals with chronic illnesses or disabilities who need health and long-term care services for more than 120 days, and who are able to safely live at home. While these patients are eligible to enter a nursing home, they choose to receive healthcare and coordinated services at home, which allows them more flexibility and the ability to stay in their community as long as possible.
“North Shore-LIJ’s Home Care Network has been providing quality home health care services for more than 30 years, so it is a logical step for us to offer long-term care services through managed Medicaid insurance,” said Howard B. Gold, executive vice president of managed care and business development at the North Shore-LIJ Health System.
North Shore-LIJ Health System’s Home Care Network has expertise in taking care of patients with chronic conditions such as heart failure, chronic obstructive pulmonary disease, diabetes and other illnesses, delivering that care to patients living at home. The Home Care Network is currently providing care to approximately 600 patients in Lynbrook who are participating in a “nursing home without walls” program known as the Lombardi program. The state’s Medicaid redesign initiative requires that Lombardi patients enroll in a Medicaid MLTC plan; it is expected that most of the patients already being served by the health system’s Home Care Network will become members of North Shore-LIJ’s new MLTC plan. The majority of these patients are elderly with chronic diseases.
The North Shore-LIJ Health Plan provides its members with a multi-disciplinary care team comprised of a nurse, social worker and service coordinator; this team works closely with MLTC members and their families to develop an individualized care plan. The team will coordinate health care services that may include a home health/personal care aide, nursing home care, home health care, adult day care, social day care, home-delivered meals, rehabilitation therapies, optometry, dental and foot care, and transportation to health-related appointments.
North Shore-LIJ Health Plan’s managed long-term care plan is part of a portfolio of products being launched to complement the services North Shore-LIJ Health System offers as the region’s largest integrated delivery system. “North Shore-LIJ Health System’s mission is to help improve the health of the communities it serves.
Having multiple insurance products that are managed by North Shore-LIJ CareConnect and North Shore-LIJ Health Plan--products that primarily use the Health System’s providers--will allow for a far greater coordination of services and go a long way toward achieving this mission, while improving outcomes and cost,” said Alan J. Murray, North Shore-LIJ CareConnect’s president.
To be eligible for services from North Shore-LIJ Health Plan’s MLTC plan, enrollees must (a) be 18 years of age or older; (b) be a resident of Kings, Nassau, New York, Queens, Richmond or Suffolk County; (c) be Medicaid eligible or dual eligible with Medicare; (d) be able to return to or remain at home without risk to health or safety as determined by the care manager; (e) require long-term care services for at least 120 days; (f) have a physician or choose a physician willing to work with North Shore-LIJ Health Plan’s MLTC plan; and (g) agree to receive the covered services through North Shore-LIJ Health Plan’s MLTC plan.
If you are interested in enrolling in North Shore-LIJ Health Plan’s MLTC plan, call (855) 421-3066.
About North Shore-LIJ Health System
The nation's 14th-largest health care system, North Shore-LIJ Health System delivers world-class clinical care throughout the New York metropolitan area, pioneering research at The Feinstein Institute for Medical Research and a visionary approach to medical education highlighted by the Hofstra North Shore-LIJ School of Medicine. North Shore-LIJ Health System cares for people at every stage of life at 16 hospitals and outpatient physician practices throughout the region. North Shore-LIJ Health System’s owned hospitals and long-term care facilities house more than 6,000 beds, employ more than 10,000 nurses and have affiliations with more than 9,400 physicians. With a workforce of more than 46,000, North Shore-LIJ Health System is the largest employer on Long Island and the third-largest private employer in New York City. For more information, go to www.northshorelij.com.
About North Shore-LIJ Health Plan
North Shore-LIJ Health Plan provides a managed long-term care program for adults who want to and are able to live safely at home, and who need long-term care services for more than 120 days. It is available to adults who are eligible for Medicaid and who live on Long Island or in Brooklyn, Manhattan, Queens or Staten Island.
About North Shore-LIJ CareConnect Insurance Company, Inc.
Aiming to make it easy for people to get and stay healthy, North Shore-LIJ CareConnect Insurance Company, Inc. offers members a single source for their health care needs: with just one phone call, they can purchase health insurance, schedule an appointment with a doctor, get answers about a medical bill and more. As part of the North Shore-LIJ Health System, North Shore-LIJ CareConnect can provide members access to all of the benefits of the health system while managing costs and keeping premiums low.