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February 2012 |
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For more than 40 years CQL has been a leader in working with human service organizations and systems to continuously define, measure and improve the quality of life of all people. Services that are person-centered ... that support each person to live his or her own life - to plan, to contribute, to participate, to choose; and to be respected and valued is WHAT REALLY MATTERS.
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Personal Quality of Life: The Missing Metric in Managed Long-Term Supports and Services (LTSS) |
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by James F. Gardner, PhD
CQL President and CEO
A severe economic downturn during the past five years, the changing demography of people with disabilities, mental illness and substance use disorders and aging adults, coupled with an increasing demand for direct support professionals, and state budget constraints have increased the emphasis on managed care alternatives instead of traditional financing schemes for health and human services.
The continuing research on managed care suggests that extending the basic principles of managed care (models, costs and implementation) to Medicaid managed care and managed long-term supports and services (MLTSS) will be challenging.
Medicaid managed care can be complicated (and the details seemingly arcane). States, Managed Care Organizations (MCOs), and MLTSS providers are being challenged to establish standards and metrics for state and MCO systems performance. We all need to pay attention to managed care contract requirements, state performance and service quality.
While recognizing these challenges, I also want to expand our expectations. I urge all potential managed care participants, their families, supporters, providers and public officials to pay attention, to focus on the key design and operational feature of managed care – measuring the impact of the Managed Care Organization on the quality of life for each individual.
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