There are more than 7 million individuals in the United States with an Intellectual or Developmental Disability (I/DD).1 The majority of these people rely on Medicaid for their health insurance coverage while a growing number are in Medicaid managed care.2 Many states currently choose to provide both medical and behavioral health for individuals with I/DD through their managed care partners. However, several states are considering taking integration to the next level by including all benefits in a single managed care arrangement.
For many individuals with I/DD, both traditional health care services and social support are needed to live safely and successfully in the community. Many states are using Medicaid waiver authority to provide access to home and community-based services such as long-term services and supports. Tennessee is one state leading the way on the use of available Medicaid waiver authority.
Authorized through an 1115 Medicaid demonstration waiver, the community-based Employment and Community First CHOICES program in Tennessee embraces and utilizes an integrated approach to care coordination for individuals with I/DD of all ages. The program is focused on providing services to individuals with I/DD so that they gain as much independence as possible and are supported to live with their family or in their community in lieu of an institutional setting. Employment services are a critical benefit in the Employment and Community First CHOICES program. The available employment services support individuals both in learning skills to find a job and securing and keeping employment.
To run the Employment and Community First CHOICES program, the UnitedHealthcare Community Plan of Tennessee utilizes an Enhanced Support Coordination model that combines care coordination services with clinical (or behavior) supports. With a focus on positively impacting health outcomes, social needs, and employment goals for our members, the Enhanced Support Coordination model provides individuals with I/DD opportunities to fully access their communities and live independently. Looking at employment outcomes, this model along with the strong supports of the Employment Specialist as well has helped us support more than 100 of our members in securing both regular wage employment and self-employment.
In addition to the positive impacts for our members, the Enhanced Support Coordination model has helped develop more confident and better trained caregivers and staff while reducing the need for long-term interventions. Though the Enhanced Support Coordination model was only implemented two years ago in Tennessee, the impact has been significant and is suggestive of a more effective means of supporting people with I/DD, including those with the most complex and challenging behavior support needs. To learn more about our health plan’s Enhanced Support Coordination model in Tennessee, read more in our newly released whitepaper, Enhanced Support Coordination.
At UnitedHealthcare, we are dedicated to ensuring individuals of all ages and capabilities have access to the services they need to live healthier lives in the community, as well as greater flexibility and control over their own lives. The work with our state Medicaid agency partner in Tennessee is just one example of the positive impact of integrating care and focusing on the whole person when caring for the individuals we serve so that they can live full and independent lives.
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173221/
