Managed care presents a model for delivering health care services in such a manner that improves health outcomes and lowers cost. The overarching goal for people with intellectual and other developmental disabilities supported in a managed care system has to be quality-driven and person/family-centered. The supports offered must be integrated and coordinated, blending needed medical services with habilitation services in all life domains, without barriers for opportunity or access. Managed care payment models must provide sufficient resources and flexibility to both the individual and the larger population, and must also allocate adequate administration payments to providers
Regardless of the service delivery/payment strategy developed, a seamless “no wrong door” philosophy and practice, coupled with person
-centered outcome measures aimed at enhancing quality of life, must be actionable in every life domain.
It is The Arc New York’s position that managed care will best serve the health and habilitation needs of people when:
- Services and supports are delivered in a quality manner that maximizes personal wellbeing.
- Quality metrics, including personal outcome measures, need to reflect long-term care, as well as acute healthcare needs of individuals with intellectual and other developmental disabilities.
- Financial constraints are not the prevailing factor driving the system.
- Services and supports are truly person-centered.
- No one is denied access to needed supports and services and everyone receives them in a timely fashion.
- Services and supports are offered and coordinated within the person’s community.
- Protections, health and safety, and rights are addressed in the determination of supports offered.
- The payer agencies and the agencies delivering supports, work together for the common good of the person being supported.