The inclusion of people with developmental disabilities in managed care as part of general efforts by states to enroll all Medicaid recipients in such plans was reviewed. Managed care was defined and the processes by which managed care organizations deliver services were explained. Escalating costs and utilization were discussed as the primary reason for the shift to managed care. The use of Medicaid Section 11 15 waivers by states to include Medicaid recipients was explored. The relation between acute health care and long-term care, and the utilization patterns in each, were briefly described. Finally, elements of managed care that are particularly important to people with developmental disabilities, such as care coordination, maintenance of quality, and individual and family support, were discussed.
This research was supported in part by the New Jersey Department of Human Services, Division of Developmental Disabilities, Contract No. 06PX4N.