Office for People With Developmental Disabilities

Managed Care

OPWDD’s Transformation Panel is exploring ways to better coordinate Intellectual and Developmental Disability (I/DD) services and quality health care.  The goal is to provide additional service options offering people with I/DD supports that are tailored to their needs and allow them to live in the communities of their choice.

Questions and Answers:

How does Managed Care work?

Managed care plans pay health care and service providers directly, so enrollees do not have to pay out-of-pocket for covered services or submit claim forms for care received from the plan's network of doctors and service providers.  When a person chooses to join a Managed Care plan, the Plan has a network of service providers for the person to choose from.  The person will get their care and services through the Plan’s network of providers.

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How can Managed Care benefit my loved ones and me?

Managed care promotes community care and provides assistance to caregivers and family members who are supporting individuals with intellectual developmental disabilities.  Managed care provides person centered planning to support a person’s specific needs.

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What Managed Care options are available for people with intellectual and developmental disabilities?

Managed care promotes community care and provides assistance to caregivers and family members who are supporting individuals with intellectual developmental disabilities.  Managed care provides person centered planning to support a person’s specific needs.

  • Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD)
  • Program of All-inclusive Care for the Elderly (PACE).  New York State is piloting a PACE program for people with intellectual and developmental disabilities.  This program is being funded through the Balance Incentive Program

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What is Managed Care?

Managed Care is a term that describes a health insurance plan or health care system that coordinates the provision, quality and cost of care for its enrolled members.  Managed Care is designed to coordinate care effectively and provide better access to services and supports.

The CCO/HH will provide care management and coordination services that are tailored specifically to help people with I/DD and their families coordinate all services. 

CCOs/HHs work with individuals with I/DD and their families to bring together health care and developmental disabilities service providers to develop an integrated, comprehensive care plan (known as a “Life Plan”) that includes health and behavioral health services, community and social supports, and other services.  CCO/HHs will assist individuals and families with accessing services that support well-rounded and fulfilling lives. 

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