Public Managed Care for Older Persons and Persons with Disabilities
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.
| 1995.Nov_.public.managed.care_.older_.persons.disabilities.issues.initiatives.pdf | 2.7 MB |

For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 























































































































































