DCCOs usually are established as new organizations rather than as an offshoot or product line of an existing organization, their start-up and operations leveraging strong alliances among multiple stakeholders – providers, consumers, advocates and payors. They contract with the state Medicaid agency generally under a prepaid capitation arrangement, but some DCCOs have fee-for-service arrangements.  Capitated arrangements allow for provider choice of the right benefit to meet the individual’s unique needs and reward DCCO’s ability to retain cost savings.

DCCOs coordinate care for persons with disabilities and/or chronic disease through teams of nurses and social workers who partner with the client and with community providers and vendors to arrange disability-competent medical, social and life care services.  We identified six core clinical activities common to all the DCCOs in this study: 

¨      Comprehensive physical, psychosocial, functional and environmental assessments;

¨      Self-directed, person-centered planning;

¨      Support with scheduling and keeping health visits;

¨      Centralized medical-social record;

¨      Focus on patient education and behavioral modification, and

¨      Constant (24/7) communication availability between and among consumers, providers and care coordination staff. 

 We also identified three core business competencies: 

¨      Coordination of all health and life care services (360 degree coordination of benefits),

¨      Engaging the community resources;

¨      Continuous enhancement of the organization’s competency to address the unique needs of persons with disabilities and chronic disease. 

DCCOs are making significant strides in empowering persons with disabilities to self manage their complex needs and realize improved health states.