As a growing number of states expand managed care programs for SSI-eligible adults, innovative managed care programs that integrate health and social services for people with disabilities are emerging to respond to the unique needs of this population. This report, which refers to these new entities as Disability Care Coordination Organizations (DCCOs), details programs in six states, describing the governance, financing, benefits and services provided, operational structure, care coordination activities, and quality programs.

The paper outlines seven key recommendations for states to consider as they design and implement DCCOs for adults with disabilities:

1. Ensure that DCCOs are grounded in the infrastructure of the community served.
2. Develop mechanisms for formal input by beneficiaries into governance.
3. Design fully capitated programs if possible; if not, at least partially capitate and ensure that DCCOs can financially benefit from care coordination savings.
4. Allow DCCOs to compile all data on carved-out services, such as mental health or pharmacy expenditures.
5. Ensure that DCCOs have a sophisticated management information system.
6. Track quality of life outcomes, in addition to satisfaction, clinical, utilization, and financial outcomes.
7. Track utilization and pay for care coordination services.