A growing number of states are planning, implementing, or expanding Medicaid managed care programs for people with disabilities. In choosing program features, states are faced with a wide array of potential options. One design element that has critical implications for program success is the enrollment model. Both the voluntary and mandatory enrollment models offer benefits and drawbacks from the consumer, state, and MCO perspectives, but states are encouraged to look beyond these more traditional options.

This technical assistance brief describes managed care enrollment options for people with disabilities, including a new hybrid model – opt-in, opt-out enrollment – that shows promise in Wisconsin for satisfying consumers as well as state and MCO partners.