Kalos Health Inc. is closing amid changes to Medicaid reimbursement. The change could challenge access to home-based services for chronically ill adults in western New York.

The nonprofit provided health insurance coverage across six counties in New York through a Medicaid managed long-term care (MLTC) plan. Since 2014, the plan has coordinated with regional health care providers to serve adults with chronic illness and health disabilities.

Kalos Health is part of The Hospice and Palliative Care Group (HPCG), an organization that provides administrative services. Other providers in the group include Niagara Hospice, Liberty Home Care, Hospice of Orleans and The Niagara Hospice Alliance.

A main goal of Kalos Health’s MLTC plans has been helping seniors continue to age in place rather than transitioning to more expensive care settings. This has involved collaborating with hospice and home care providers to offer Medicaid beneficiaries services at no cost, including home care services, meal deliveries, day programs and therapies, as well as transportation to medical appointments.

Recent changes in Medicaid funding have made sustainability of MLTC coverage difficult to navigate, Kalos Health CEO Carlo Figliomeni told local news.

Federal funding cuts included in the 2025 budget reconciliation bill have reduced the ability to cover services and resulted in higher costs for Medicaid, according to Figliomeni. Changes to Medicaid have hindered economic stability and caused participating providers to close.

Kalos Health ceased accepting new beneficiaries to its long-term care plan as of Oct. 1, 2024. Registered nurse care managers at Kalos Health have coordinated with health care providers to address unmet needs among a diverse patient population.

The health plan had a long-term collaboration with providers such as Lockport, New York-based ​​Niagara Hospice, which offers palliative care, caregiver resources, bereavement, dementia care and telehealth services. The hospice also offers veteran, ambulette and durable medical equipment services, as well as a Pet Peace of Mind program. Established in 1980, the nonprofit serves more than 1,000 patients annually and operates a general inpatient facility, Niagara Hospice House, which opened in 2007.

Closure of the Medicaid managed long-term care program comes at a time of rising demand.

An estimated 3.9 million adults in the Empire State have a disability, of which more than half (57.7%) have multiple chronic conditions, reported the New York State Department of Health.

Nearly one-in-five individuals are 65 and older in New York state, according to a 2023 report by the Center for an Urban Future (CUF). Poverty rates among seniors are increasing statewide, particularly across underserved patient populations in the metropolitan areas of New York City, a recent CUF report found.