A Market Assessment for a Managed Medicaid Long-Term Care Health Plan
Client/Profile
A managed Medicaid long-term care health plan
Challenge/Situation
To determine if a managed Medicaid long-term care health plan should expand its operations to other states. In light of expanding and evolving Medicaid programs across the country, our client was interested in exploring opportunities to offer its long-term care health plan product elsewhere and grow their business.
Process
Veralon researched managed Medicaid long-term care (“LTC”) or managed long-term services and support (“LTSS”) coverage and product offerings in states where our client was not yet operating.
Many states are in some stage of implementing managed LTSS programs; some states are offering stand-alone LTSS plans, while others are combining insurance coverage for medical and LTSS care into a single capitated arrangement. Coverage for individuals with dual-payer eligibility was also evaluated.
We evaluated our client’s ability to expand to other states based on the target population for this type of service, on state policy; potential market opportunity; current and future managed LTSS plan offerings from other payers.
Results
Several good target markets were identified for the client.