For a five-year period beginning November 1993, staff at the Community Coalition for Long Term Care—a coalition of Monroe (N.Y.) county agencies, BlueCross/BlueShield, local health care providers and advocacy organizations—conducted a demonstration project to develop and implement Continuing Care Networks. The networks were meant to integrate and capitate primary, acute and long-term care for all Monroe County residents age 65 and over.

The coalition also conducted a study of the feasibility of linking the Continuing Care Networks to a public-private partnership that enables purchasers of qualified, private, long-term-care insurance to be eligible for Medicaid without having to spend their life savings once their insurance benefits are exhausted.

The project was part of the Robert Wood Johnson Foundation (RWJF) national program, Building Health Systems for People With Chronic Illnesses.

Key Results:

• As of March 1997, 322 individuals were enrolled in two Continuing Care Networks on a fee-for-service basis.
• In 1999 the demonstration project received a federal waiver from the Health Care Financing Administration (since renamed the Centers for Medicare & Medicaid Services, or CMS). Project staff discontinued the project when CMS, citing budget limitations and other priorities, withdrew the waiver in 2002.

Feasibility Study Key Findings:

• The focus group study revealed that the group most interested in an integrated managed care/long-term-care insurance product was already enrolled in a Medicare managed care plan that had purchased a long-term care insurance policy.