As many states expand their use of managed care in Medicaid, a growing number of
beneficiaries with disabilities are being enrolled in risk-based managed care
arrangements for at least some of their care. Further growth in managed care is
expected in 2014, when the Affordable Care Act expands Medicaid eligibility to
many uninsured low-income adults, including those with disabilities.
This
issue brief looks at issues related to the development and implementation of
managed care programs with the capacity to serve Medicaid beneficiaries with
disabilities. Drawing on existing research on Medicaid managed care and people
with disabilities, the brief highlights policy considerations related to setting
plan payment rates, developing adequate provider networks and delivery systems,
and ensuring sufficient beneficiary protections and plan oversight.
The
brief considers the wide range of intensive and specialized medical and
long-term care needs facing Medicaid beneficiaries with disabilities that may
include spinal-cord and traumatic-brain injuries, cerebral palsy, autism,
Alzheimer’s disease and severe mental illness, and the challenges states face in
designing effective managed care programs that successfully meet those needs.
Issue Brief (.pdf)
