Biomaterial Database

Medicaid managed care meets developmental disabilities: proceed with caution. 2003

Norma L Goel, and Robert H Keefe

School of Social Work, Syracuse University, NY 13244-1230, USA.

This article examines Medicaid managed care's potential impact on people with developmental disabilities. The authors discuss how the philosophy behind the skills/functional model of service provision for people with developmental disabilities is incongruent with the medical model of managed care. They discuss the policy issues that various states have had to face concerning Medicaid managed care's administration of health benefits for people with developmental disabilities. They extrapolate from the research on managed care to formulate potential models that states might use to administer the health benefits for people with developmental disabilities. Finally, the authors propose policy and research agendas to begin investigating Medicaid managed care's potential impact on people with developmental disabilities.

UI	MeSH Term	Description	Entries
D008134	Long-Term Care	Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care.	Care, Long-Term,Long Term Care
D008329	Managed Care Programs	Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.	Case Management, Insurance,Insurance Case Management,Managed Health Care Insurance Plans,Managed Care,Care, Managed,Managed Care Program,Management, Insurance Case,Program, Managed Care,Programs, Managed Care
D008484	Medicaid	Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.	Dental Medicaid Program,Medical Assistance, Title 19,Dental Medicaid Programs,Medicaid Program, Dental,Medicaid Programs, Dental,Program, Dental Medicaid,Programs, Dental Medicaid
D009936	Organizational Innovation	Introduction of changes which are new to the organization and are created by management.	Organizational Change,Change, Organizational,Innovation, Organizational,Changes, Organizational,Innovations, Organizational,Organizational Changes,Organizational Innovations
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D002658	Developmental Disabilities	Disorders in which there is a delay in development based on that expected for a given age level or stage of development. These impairments or disabilities originate before age 18, may be expected to continue indefinitely, and constitute a substantial impairment. Biological and nonbiological factors are involved in these disorders. (From American Psychiatric Glossary, 6th ed)	Child Development Deviations,Child Development Disorders,Child Development Disorders, Specific,Developmental Delay Disorders,Disabilities, Developmental,Development Disorders, Child,Child Development Deviation,Child Development Disorder,Development Deviation, Child,Development Deviations, Child,Development Disorder, Child,Developmental Delay Disorder,Developmental Disability,Deviation, Child Development,Disability, Developmental
D003156	Community Mental Health Services	Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.	Community Mental Health Service,Mental Health Services, Community,Assertive Community Treatment,Health Services, Community Mental,Services, Community Mental Health,Services, Mental Health Community,Community Treatment, Assertive,Treatment, Assertive Community
D003266	Continuity of Patient Care	Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.	Continuum of Care,Continuity of Care,Care Continuity,Care Continuity, Patient,Care Continuum,Patient Care Continuity
D003688	Deinstitutionalization	The practice of caring for individuals in the community, rather than in an institutional environment with resultant effects on the individual, the individual's family, the community, and the health care system.	Deinstitutionalized Persons,Deinstitutionalized Person,Person, Deinstitutionalized,Persons, Deinstitutionalized
D004185	Disability Evaluation	Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits.	Disability Evaluations,Evaluation, Disability,Evaluations, Disability