MANAGED CARE
and the Lives of People
with Developmental Disabilities
and their Families
(updated 7/30/97)





In response to several visitors, we're devoting as much space as possible to information about managed care and the impact on people with developmental disabilities and their families. We will present as much of a balance as we can in the articles and links that we find regarding this topic. If you have comments or questions, please send them them to us and we will try to post them as quickly as possible.

(Note on 7/31/97: This has been a difficult topic for us to keep current on. As you will see, most things here are over a year old. Hopefully, it's still useful information, but for a more current site specific to this topic, please travel to The National Clearinghouse on Managed Care and Long-Term Services and Supports for Adults with Developmental Disabilities and Their Families. )

Here is how The Accreditation Council recently described the term managed care in a brief article.

Managed Care refers to the cooordinated attempt to control health care costs through a variety of strategies and methodologies. The basic strategies and methodologies address utilization of services, the prices paid to providers, and the price paid by the user. Managed Care strategies include risk management, utilization management, prior authorization, concurrent review, limitation of benefits, peer practice review, service coordination, channeling, bundling, and prevention and health promotion.

In the past, we equated managed care with health maintenance organizations. Now, however, managed care has taken a center stage in the delivery of health care. The movement toward managed care is driven by the increase of health care costs and the increase of uninsured citizens. Both are rising at the same time.

For the past decade, large businesses and corporations have supported managed care as a means to controlling their health care costs. More recently, states have begun to shift Medicaid recipients to managed care programs. In addition, states have begun to shift mental health and addictions services into managed care systems. Finally, states are now attempting to extend managed care systems to the services and supports for people with developmental disabilities.
Excerpted from
Update on Quality
Volume12, Number 3
October, 1995

Complete article here


Here's an interesting quote we found in that same article:

Identifying and addressing specific and priority outcomes for the individual is more cost effective than providing a broad range of less important services.



The Center on Human Policy at Syracuse University has developed A Position Paper on Managed Care and Long-Term Supports in Developmental Disabilities.



This reminded us of an analogy that Larry Naeve (CITY Community Services) once shared with us:

Mr. Jones has a leaky faucet, calls a plumber, and she comes to his house to install a water heater. At first, he passes it off as an aberration. The water heater didn't cost him anything, and although he had to fix the faucet himself, he ends up with a sparkling new water heater. Sometime later, Mr. Jones has a leaky toilet, and again calls the plumber. She decides that he really needs another water heater, and installs it. Finally, Mr. Jones throws up his hands, and turns elsewhere for help.







The National Association of State Directors of Developmental Disabilities Services, Inc. has just completed a new publication titled Managed Care and People with Developmental Disabilities: A Guidebook.










Also, the Arc has a good overview article titled Managed Care and Long-term Services for People with Mental Retardation in the Question and Answer section of their home page and you can get right to it from here.





Here's another great resource. You can subscribe to a list server that HSRI (Human Services Research Institute, Boston) set up to exchange information about managed care and people with disabilities. If you want to get on the list, you need to send an e-mail message to:

LISTSERV@SJUVM.STJOHNS.EDU

containing only the words:

subscribe MCAREDIS firstname lastname
[[[[e.g., subscribe MCAREDIS John Shea]]]

After you send the message, you will get a confirming message back. After that, all messages will come into you via e-mail. This is how the mailing list is described by HSRI: The purpose of the MCAREDIS mailing list is to provide information and contacts regarding managed care approaches to serving people with disabilities. Increasingly policy makers are looking to managed care as the way to contain the costs of serving people with disabilities and to provide more flexible, accountable and outcome-driven systems of service. This network will foster discussion regarding the merits and limitations of different approaches from a variety of experiential and theoretical perspectives.



Here's an important visitor request for information.






A brief glossary of managed care concepts (of which we are searching for an author.







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