title: Consumer direction in managed long-term care: an exploratory survey of practices and perceptions.
abstract: OBJECTIVE
  This article presents results of a survey of the attitudes and practices of managed care organizations (MCOs) concerning consumer direction. The study focused on understanding several alternative measures of consumer direction and the factors that are associated with the MCOs concerning those measures.
  
  
  METHODS
  The MCOs that were surveyed provided capitated managed long-term care benefits to their Medicaid-eligible clients and were chosen because personal assistance service is a likely area for consumer-direction interest or practice.
  
  
  RESULTS
  Although the majority of the responding MCOs were found to be practicing some form of consumer direction, the experience is limited and underdeveloped. Two areas of concern seem to be most important in an organization's decision to adopt a consumer choice or consumer-direction model: the balance of concerns about unprofitability and the perceived interest and benefit of the clients.
  
  
  CONCLUSIONS
  This study suggests managed care and consumer direction can work together and provides a baseline to assess further development of their compatibility.
authors.affiliation: University of Maryland, Center on Aging, College Park 20742, USA. mm56@umail.umd.edu
authors.forename: Mark R
authors.initials: MR
authors.lastname: Meiners
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Mahoney
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Shoop
authors.forename: Marie R
authors.initials: MR
authors.lastname: Squillace
mesh_terms: D003256:Community Participation; D003258:Consumer Behavior; D003625:Data Collection / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration*; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid / Q000191:economics; D014481:United States