Across the country, states are exploring how to provide more cost-effective managed care for people with disabilities. Those who have embraced Medicaid managed care for this population believe it can deliver better access and quality at a more predictable cost. To help policymakers determine whether such an approach might be appropriate for California, the Medi-Cal Policy Institute commissioned the Center for Health Care Strategies to determine how well managed care for people with chronic illnesses and disabilities has functioned in four other states: Massachusetts, New Jersey, Oregon, and Pennsylvania.

The perspectives from the interviews in this study provide valuable insights for consideration in six priority areas of managed care for people with disabilities. These include model design; beneficiary enrollment and consumer engagement; financing, rate setting, and cost containment; network adequacy; care coordination and carve-outs; and quality monitoring and improvement. The firm consensus among states and health plans is that some form of managed care is the best path to take in meeting the needs of this population. Consumers, while less sure, also agreed that managed care offers the potential for better access and increased quality.