We all know that nursing homes can be expensive. Even way back in the good old days of 2012, the median cost of a private room in a nursing home was nearly $100,000 per year. However, in 2018, there may be some relief for seniors wishing to stay in their homes and avoid nursing home care.

Beginning with 14 counties in southwestern Pennsylvania—Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington and Westmoreland—the new Community HealthChoices (CHC) initiative will roll out in January 2018. Committed to increasing opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes, Community HealthChoices will coordinate health care coverage to improve the quality of health care. The initiative will roll out to Philadelphia and its four surrounding counties in 2019, and the remaining 48 counties across central and northern Pennsylvania will be in 2020.

What it means

This shift means insurers will be paid to manage Medicaid’s long-term care services, with a financial incentive to get enrollees the nursing care and services they need in a home, where it is roughly half as expensive as a nursing home. Those who qualify for government-funded services due to their health and income limitations will select one of three new managed care organizations to coordinate their health and long-term care services.

Who will be affected

About 80,000 individuals in the 14 southwestern Pennsylvania counties—most of whom qualify for both Medicare and Medicaid support—will be the first in the state participating in Community HealthChoices. 

Start planning today for your long-term care and nursing home care to meet your individual needs of the future.