Barriers to care coordination of medicaid-funded, community-based long-term services and supports

Medicaid-funded Long-Term Services and Supports (LTSS) include a range of healthcare delivery services provided for qualified Medicaid recipients in need of ongoing care. As of 2013, four million people in the United States received Medicaid-funded LTSS. These costly services are provided either in the community or in a facility. Many states, including New York, have moved to encourage more community-based LTSS because of the expense and negative stigma associated with facility-based care. The purpose of this study was to identify the barriers to care coordination in obtaining or maintaining community-based LTSS for Medicaid members in New York State. The significance of this study is to emphasize the barrier management efforts of care coordinators to keep LTSS in place. Data collection occurred between June and August of 2015 through key informant interviews with seven care coordinators from six community agencies in Erie and Niagara Counties. Key informants were selected based on their care coordination experience with the Medicaid-funded LTSS population. A thematic analysis was conducted to categorize responses according to key informants' experience with care coordination barriers. The findings help explore barriers in this population as well as care management strategies to resolve the barriers.