For the Elderly, Is Managed Care a Good Option? "Advocates Say Managed-Care Plans Shun the Most Disabled Medicaid Users" (front page, May 1) unfairly suggests that managed long-term care plans are inappropriately denying services. Previously, enrollees received hours of care that did not match their need for services. Health plans develop person-centered plans of care based on patient-specific assessments. Plans have matched care to individual needs, reducing excessive use, improving quality and saving taxpayer dollars. The article also suggests that plans target enrollment of healthier individuals. However, payments are proportional to each member's level of care need. Plans receive higher payments for sicker enrollees and lower payments for healthier enrollees. This payment method is explicitly intended to reduce incentives for selective enrollment. Since January 2012, 46,000 people have joined managed long-term care plans. While no system is perfect, most people have moved smoothly to managed care. If enrollees disagree with their proposed plan of care, an independent appeals process protects members. Managed long-term care plans have improved care management and quality while reducing costs. PAUL F. MACIELAK President and Chief Executive New York Health Plan Association Albany, May 2, 2013 This article and other recent articles offer the public a much-needed understanding of the problems that arise when a new government program is rolled out in haste. Advocates have repeatedly argued that the implementation of New York's new Medicaid managed long-term care program is being rushed and have called for a delay. The shameful stories of greed and deception as described in your articles point to the imperative for the state to halt implementation. State officials must work with advocates and providers to ensure that thoughtful and transparent operations are in place before the plan is foisted upon the vulnerable elderly and the disabled who rely upon it for their health care. The writer is chairwoman of the Health Committee of the Women's City Club of New York.