Major Issues and Selected Initiatives
Interest in managed care for older persons and persons with disabilities has intensified in recent years, as states and the federal government have searched for ways to make publicly funded programs more effective and less costly. The heightened interest has stimulated a lively debate among consumers, policy makers, advocates and providers regarding the impact of managed care on older persons and persons with disabilities, with much of the debate based on anecdotal evidence. Part 1 of this paper identifies major policy and program issues that have emerged from the debate and discusses the limited research to date that bears on those issues. Part 2 describes selected managed care initiatives for older persons or persons with disabilities. A few of the initiatives described in Part 2 (such as medicare HMOs and Arizona’s ALTCS program) have been evaluated extensively, but most are new efforts likely to provide a trove of experience to analyze as the debate continues.