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Guidelines for Successfully Enrolling People with Disabilities in Managed Care Plans

Authors: National Council on Disability


In response to plans for the use of managed care in Medicaid funded long-term care supports, the National Council on Disability developed a set of 20 principles for states to use in setting up their plans. Here is an excerpt from the NCD website explaining their purpose:

“In the current state and federal policy environment where reducing public expenditures is a primary aim of public policy, there is a significant risk that vulnerable people with disabilities will be the victims of poorly conceived and executed public policies that fail to meet their needs. If such results are to be avoided, it is essential that the principles articulated below are meticulously observed in designing and carrying out managed care initiatives involving people with chronic disabilities. Done right, all stakeholders will benefit.”

The principles are organized under the following four headings:

I. Personal Experience and Outcomes
(subheadings are Community Living, Personal Control, Employment, and Support for Family Caregivers)

II. Designing and Managing a Managed Care System
(subheadings are Stakeholder Involvement, Cross-Disability, Life-Span Focus, Readiness Assessment & Phase-In Schedule, Provider Networks, Transitioning To Community-Based Services, Competency & Expertise, Operational Responsibility & Oversight, Continuous Innovation, Maintenance of Effort & Reinvesting Savings, and Coordination of Services & Supports)

III. Managed Care Operating Components
(subheadings are Assistive Technology & Durable Medical Equipment, and Quality Management)

IV. Participant Rights
(subheadings are Civil Rights Compliance, Continuity of Medical Care, Due Process, and Grievances & Appeals)

Description based on an online review of the full document viewed online on 7/11/12 at http://www.ncd.gov/publications/2012/Feb272012/ click on the “Web Links” tab above to go to the full document.

Contact Info:
Name:Aaron Bishop
Title:Executive Director
Organization:National Council on Disability
Address:1331 F Street, NW, Suite 850
Washington, D.C. 20004
Phone:(202) 272-2004
Fax:(202) 272-2022
Cost:No Cost

Web Links

Link to the Document

National Council on Disability Homepage

This information was found at www.qualitymall.org