Calif. Nursing Homes Monitor Insurer Cut Fallout

Health Net’s decision to cut assisted living benefits for 3,500 low-income Californians has some consumer advocates in the state concerned about where those individuals will live and nursing homes wondering if those cut could be coming their way.

The nursing home sector in the state said it is watching the situation for potential impact on its members, according to the California Association of Health Facilities.

Media reports said CalViva Health and Community Health Plan of Imperial Valley, which contract with Health Net to provide services, have also told the state of their intent to discontinue assisted living benefits.

The assisted living benefit is part of CalAIM, California's Medi-Cal overhaul, which was designed to improve care while reducing repeat ER visits and pricey hospital stays.

The reports said Health Net argued that the Medi-Cal program brought people from home to assisted living, instead of moving people out of the nursing home and into lower cost settings and has not led to better care for those in the program.

For its part, the insurer said the 3,500 people affected would not be left without services and end up unhoused when the benefit cut goes into effect at year’s end.

“Affected members will receive care through their individual authorization date, and could be transitioned to nursing homes, back home with in-home supportive services, or to other programs,” according to the Health Net statement.

Comments? Contact Patrick Connole at pconnole@parkplacelive.com.