Abstract
This paper discusses some of the broad considerations that must be weighed in designing and administering payment systems for community developmental disabilities services during the 1990s. Key features of the current policymaking environment are examined to convey a sense of the framework within which current state policies are being established. In addition, the authors (a) analyze the complex factors which state policymakers have to take into account in their efforts to improve present community rate-setting and reimbursement policies, and (b) outline major trends in state-level rate-setting practices over the past several years. The paper concludes with a discussion of the need for consensus on basic programmatic directions as a precursor to effective reimbursement design.
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