Medicaid Managed Care - U.S. Senate Special Committee on Aging

In selecting managed care entities state
policies should give preference to non-profit
organizations and/or existing, statutorily
recognized local administering agencies.
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Policies Governing MCO Procurement (Cont'd)
* A commitment to promoting innovative support strategies, including consumer-directed alternatives;
* A solid track record in working constructively with service provider agencies to achieve improved
performance and responsiveness;
* Clear organizational capabilities to fulfill the requirements spelled out in the procurement
specifications that are based on the managed care plan;
* Demonstrated capabilities in establishing effeetive and productive linkages with other community
resources and organizations;
. Financial solvency;
. A well-articulated quality assurance and quality improvement plan;
* Willingness to contract on a performance basis, including the use of incentives and penalties
based on negotiated benchmarks that address access to services, timely response to consumer
needs, consumer satisfaction, and desired outcomes; and
. An effective management information system, plus appropriate equipment and technological
capabilities. -
CONCLUSION
In addition, states should encourage the
development of multiple, locally-based
managed care organizations in order to
foster effective ties to local communities.
Public developmental disabilities service systems must confront the enormous challenges
posed by modifications in federal and state policies which are likely to impose strict limits
on the dollars available to meet current and future service demand. These systems must
embrace productivity improvement as a central goal while keeping faith with their core mission
and values.
<strong>Managed</strong> care approaches can be valuable tools in unifying existing service systems
and allowing them to deliver 'what's needed, no more, no less" effectively and efficiently.
Service systems must be designed to advance the essential public policy aim of enabling
people with developmental disabilities to live full, productive, self-determined, everyday lives
in their communities. Individuals with disabilities, their families and other stakeholders must
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