Examining Managed Care
OPWDD has invested a portion of its American Rescue Plan Act funding into studying and exploring the potential effectiveness of a Managed Care payment model for developmental disabilities services in New York State.
The assessment examines whether Managed Care or a different model can help OPWDD achieve its strategic goals of providing equitable access to high quality, person-centered, needs-based services.
The Office for People With Developmental Disabilities has not made a decision on whether or not to utilize Managed Care to pay for HCBS waiver services outside of the existing demonstration plan (FIDA-IDD), at this time. The evaluation is one step toward helping OPWDD understand if Managed Care or other models would help better meet people’s needs. The results of the assessment will inform next steps which will include further opportunities for dialogue and engagement prior to any decisions being made.
Assessment
OPWDD retained Guidehouse, Inc. to conduct the Managed Care evaluation. In December 2022, Guidehouse issued its initial report, and in August of 2024 the Final Report was issued.
Throughout Guidehouse’s assessment of Managed Care, there were several opportunities for stakeholders to provide feedback, including stakeholder surveys, town hall meetings, and conversations with advisory boards.
Initial Report & Presentation
Resources Provided to Guidehouse by OPWDD
- The New York State Medicaid State Plan
- The New York State Medicaid State Plan covers the following OPWDD services:
- Article 16 (OPWDD certified) clinic,
- day treatment,
- health home/care coordination services,
- specialty hospital, and
- Intermediate Care Facility for Individuals with Intellectual and Developmental Disabilities (ICF-IID).
- The New York State Medicaid State Plan covers the following OPWDD services:
- 1915 (c) Waiver
- 1915 (c) OPWDD Comprehensive Waiver for children and adults with Intellectual or Developmental Disabilities, including autism.
- 1115 Waiver
- 1115 waiver amendments.
- 2023-2027 OPWDD Strategic Plan
- The Strategic Plan will guide OPWDD policy and planning efforts for the next several years, focusing the agency on achieving identified goals and objectives in continued partnership with people with developmental disabilities, their family members, and service providers.
- ARPA Spending Plan
- OPWDD spending plan for the funds provided through the American Rescue Plan Act (ARPA) of 2021.
- HCBS statewide transition plan
- New York State Statewide Transition Plan (STP) to achieve compliance with the Home and Community-Based Services (HCBS) Final Rule.
- OPWDD Data Book
- Publicly available June 2023 data book that provides past utilization data up through June 2022.
- New York Alliance for Inclusion and Innovation’s Report
- 2020 Report that examines other states’ implementation experiences with Managed Care for the I/DD population.
- Final Report: Intellectual and Developmental Disability Care Evaluation Prepared for Texas Health and Human Service Commission
- 2018 report to share comprehensive research findings of existing care options for the intellectual and developmental disability (I/DD) population across the United States.
- IDD LTSS Carve-In Cost-Effectiveness Evaluation – Final Report Prepared for: Texas – Health and Human Services Commission
- 2019 report to evaluate the cost-effectiveness of Managed LTSS (MLTSS) for individuals with IDD.