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State Health Reform; Americans with Disabilities Act; Persons with Disabilities; Health Reform


This Policy Brief examines issues that can be expected to arise as California moves to significantly expand the use of mandatory managed care arrangements for Medi-Cal enrollees with disabilities. This analysis is based on information gleaned from more than a decade of Medicaid managed care specification analyses for the federal government and private funders, focusing on both the general beneficiary population and persons with chronic illnesses and disabilities. This Policy Brief also reflects experiences in furnishing technical assistance to state purchasers and in developing model managed care purchasing specifications for both general and special needs managed care populations for both public and private funders.

The Policy Brief begins with a brief overview of the California Redesign Initiative, which has been drawn from numerous sources of information. This overview focuses on both the scope of the initiative and the process of development to date. The Brief then describes the federal and state legal framework in which California’s managed care system will operate and identifies a series of process-related and topical issues that can be expected to arise as the state moves from broad concept stage to actual operationalization of a much expanded compulsory managed care system for children and adults with disabilities. Both sets of issues are common to all Medicaid managed care systems but take on particular importance in the context of compulsory managed care arrangements for beneficiaries with disabilities.


Funder: California Endowment.

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