Overview and implications of Medicaid managed care for people with developmental disabilities.
The inclusion of people with developmental disabilities in managed care as part of general efforts by states to enroll and Medicaid recipients in such plans was reviewed. Managed care was defined and the processes by which managed care organizations deliver services were explained. Escalating costs and utilization were discussed as the primary reason for the shift to managed care. The use of Medicaid Section 1115 waivers by states to include Medicaid recipients was explored. The relation between acute health care and long-term care, and the utilization patterns in each, were briefly described. Finally, elements of managed care that are particularly important to people with developmental disabilities, such as care coordination, maintenance of quality, and individual and family support, were discussed.
Kastner
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New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Morristown, USA.
Walsh
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Criscione
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D002658:Developmental Disabilities; D006801:Humans; D008329:Managed Care Programs / Q000191:economics; D008484:Medicaid / Q000191:economics; D008605:Mental Health Services / Q000191:economics* / Q000592:standards; D014481:United States