Value Over Volume: Payment Reform Pilots in Community I/DD Services

Our newest report details eight “key concepts” to be included in our ideal design for a program that positions it for the future of services and supports. The concepts include (1) access to services, (2) individualized budgets, (3) availability of “in lieu of” services, (4) partnership between payers and providers, (5) system structures that motivate the use of technology, (6) flexibility that contributes to staff satisfaction, (7) a clear, multidisciplinary approach, and (8) emphasis on quality outcomes and personal satisfaction.

After analyzing each of these concepts, the report concludes with the proposal of three potential APM pilots, each of which reflects a set of characteristics identified in the Working Group’s research and case studies as critical to success. This report lays out the potential structure of three model prototypes that are recommended to be piloted: (1) a prepaid inpatient health plan, (2) an “optimizing outcomes” plan, and (3) a multi-system integrated care plan for youth and adults.