Using performance-based contracts and incentive payments with
managed care: Increasing supported employment opportunities for people with
developmental disabilities
Affiliations: Denver Options, Inc. and University of Colorado at
Denver, Graduate School of Public Affairs, Denver, CO, USA | Managed Services Department, Denver Options, Inc.,
Denver, CO, USA | Center for Technical Assistance & Training
(CTAT), Denver Options, Inc., Denver, CO, USA
Note: [] Address for correspondence: Stephen Block, Ph.D., Executive
Director, 5250 Leetsdale Drive, Suite 200, Denver, CO 80246, USA. Tel.: +1 303
753 6688; E-mail: [email protected]
Abstract: Managed care delivery systems seem to be one of the primary vehicles
that policymakers have selected to control the accelerating costs of public
programs, including services to persons with developmental disabilities. The
article provides a case example of a Colorado managed care organization that
developed a performance-based funding system to improve supported employment
services for individuals with developmental disabilities. The presence of
achieved outcomes and quality indicators led to additional funding of service
agencies. Contractors were given incentives for reaching certain milestones,
such as job placement and job stabilization. To strengthen the milestone
system, a three-day intensive skill-building training program was developed for
the staff of service agencies to become or enhance skills as supported
employment consultants. Service agencies with trained staff could bill at a
higher rate for their services. Over a period of 3 years, this payment system
led to a 37% in the number of long-term job placements in the community.
