Optimizing HCBS and Healthcare Spending for People with IDD in a Time of Medicaid Cuts: 10 Strategies for Better Outcomes and Smarter Spending

Optimizing HCBS and Healthcare Spending for People with IDD in a Time of Medicaid Cuts: 10 Strategies for Better Outcomes and Smarter Spending

By Aliah Farley

As states prepare for significant shifts in Medicaid funding, providers and policymakers are asking the same urgent question: How can we continue delivering high-quality services while managing tighter budgets?

The current healthcare system for people with IDD faces unique challenges, including persistent health disparities and the high prevalence of chronic conditions that often co-occur with intellectual and developmental disabilities. These issues highlight the need for improved integration and provider training to address both acute and long-term health needs.

In a recent IntellectAbility webinar, Dr. Craig Escudé, President of IntellectAbility, and Daleigh Tallent, RN, MSN, CDDN, Clinical Director, shared strategies for strengthening Home and Community-Based Services (HCBS) and healthcare for people with intellectual and developmental disabilities (IDD). Various departments at the state and organizational level are responsible for implementing person-centered initiatives and optimizing HCBS. Together, they outlined the challenges ahead and provided ten actionable strategies to improve outcomes while controlling costs.

The Medicaid Landscape in 2025

With the recent federal budget reconciliation bill, Medicaid and CHIP face projected funding reductions of nearly $1 trillion over the next decade. States will feel these impacts differently, but the ripple effects could include:

  • Fewer HCBS waiver slots and longer waitlists
  • Increased risk of institutionalization due to loss of community supports
  • Staffing shortages and provider agency closures
  • Reduced access to behavioral health services
  • Increased administrative barriers, such as six-month re-verifications
  • Changes in eligibility criteria that may affect who is eligible for Medicaid-funded programs and long term services

Reductions in payments to providers and changes in private insurance coverage may further limit access to care for people with intellectual and developmental disabilities (IDD), especially for specialized therapies and services not fully covered by public programs.

While these possibilities paint a concerning picture, Dr. Escudé emphasized a forward-focused approach: “I don’t like to operate by scaring people. I like to say, okay, this is where we are. These are the things that we’re looking at. So, what can we do?”

The increased risk of institutionalization is particularly concerning, as it may lead to more individuals with IDD being placed in facilities or institutions, such as Intermediate Care Facilities/Intellectual Disabilities (ICF/IID), rather than receiving community-based supports. State-supported living centers and other government-supported facilities continue to provide supported care for those with higher medical and behavioral needs, highlighting the ongoing importance of both institutional and community-based options.

Ten Strategies for Optimizing HCBS and Spending

Optimizing Home and Community-Based Services (HCBS) for people with intellectual and developmental disabilities (IDD) requires understanding their unique needs and the benefits of integrated systems. These strategies aim to improve the person’s ability to live independently and achieve better health outcomes.

  1. Prioritize Prevention
    Early detection of health issues, especially in children, can improve outcomes by enabling timely intervention and support. For example, screening for physical disabilities or chronic conditions in children allows for early treatment and assistance, reducing suffering, preventing ER visits, and lowering costs.
  2. Focus on High-Risk Populations
    Identify high-risk persons and patients at greatest risk of health destabilization by understanding their chronic conditions, affected body systems, and social context. This helps tailor treatment, assistance, and resources to those who need them most, improving outcomes and ensuring that care is patient-centered.
  3. Leverage Data and Predictive Tools
    Use data and predictive tools across different provider types and systems to provide services more efficiently. This enables providers to understand patient needs, predict hospitalizations, and intervene early, improving care coordination and resource allocation.
  4. Strengthen Care Coordination
    Integrate medical, behavioral, mental health, and oral health supports, as well as medicine, to prevent duplication and missed needs. Addressing both physical disabilities and mental health needs brings significant benefits to persons with IDD. Healthcare providers play a key role in coordinating care and providing treatment for both acute and chronic conditions.
  5. Employ Technology Wisely
    Use telehealth, remote monitoring, and data sharing to reduce costly crises. These methods benefit persons with IDD by making healthcare more accessible, especially for those with mobility or transportation challenges.
  6. Adopt Value-Based Payment Models
    Value-based payment models incentivize stabilization and improved quality of life over service volume. These models result in less effort and more naturally integrated care planning, making it easier for providers and patients to update and implement service plans.
  7. Invest in Workforce Training and Retention
    Equip staff with IDD-specific training, teaching methods, and person-centered thinking skills to reduce turnover and improve care. Teaching staff to recognize and support the body’s health needs, including those related to physical disabilities, helps them better understand and implement person-centered thinking skills.
  8. Reduce Reliance on High-Cost Settings
    Expand crisis stabilization options and IDD-focused telehealth to prevent unnecessary hospitalizations. Support people in their own homes and communities to reduce reliance on high-cost facilities and institutional care. For example, the Texas Home Living Program (TxHmL) supports individuals with IDD living with their families or in their own homes, promoting independence and community integration.
  9. Address Social Determinants of Health (SDOH)
    Screen for food, housing, and transportation needs that drive health outcomes. Social services and community-based programs provide assistance to families and individuals, addressing social determinants of health and supporting participation in their communities.
  10. Engage People and Families in Planning
    Build truly person-centered plans that reflect what people actually need and want. Person-centered thinking skills are essential for supporting self-direction and promoting positive control in service planning. Involve family and family members in planning and decision-making and ensure understanding and respect for the person’s ability and preferences. Supporting individuals in this way leads to more effective, individualized care and better health outcomes.

How IntellectAbility Supports These Strategies

The strategies outlined aren’t theoretical. They are already in practice through IntellectAbility’s tools, training, and services. The aims of IntellectAbility’s initiatives are to enhance independence, self-direction, and quality of life for people with IDD, while providing measurable benefits such as improved health outcomes, increased responsiveness, and better access to integrated care.

  • Health Risk Screening Tool (HRST®)
    • The HRST is the only validated, standardized tool designed to detect health destabilization early in people with IDD.
    • It identifies risks across 22 health domains, providing actionable steps for caregivers and clinicians.
    • States, provider agencies, various departments, and State Supported Living Centers use HRST data to guide staffing, allocate resources, improve care, and even predict hospitalizations.
    • Results are measurable: fewer ER visits, fewer urgent care trips, decreased falls, reduced unnecessary medications, and longer, healthier lives.
  • The IntellectAbility Academy
    • An eLearning platform offering IDD-specific courses for staff at every level.
    • Courses on the “Fatal Five” (the top preventable causes of death for people with IDD) equip direct support professionals, nurses, and clinicians with lifesaving knowledge.
    • The Academy uses a variety of teaching methods, including interactive modules and scenario-based learning, to impart person-centered thinking skills and reinforce best practices.
    • Accessible 24/7 and designed to reduce training costs while improving staff retention.
  • Curriculum in IDD Healthcare
    • A credentialed program that prepares physicians, nurse practitioners, healthcare providers, and other clinicians to deliver competent, person-centered care to people with IDD, a population often underserved in traditional medical education.
    • These programs offer significant benefits, such as improved care quality, increased provider competency, and better health outcomes for people with IDD.
  • Person-Centered Practices
    • IntellectAbility provides training and coaching to help organizations embed person-centered thinking and planning into their culture.
    • These efforts focus on supporting staff and organizations in adopting and sustaining person-centered approaches for improved service planning and support.
    • This not only improves quality of life but also aligns directly with HCBS requirements and value-based care initiatives.

Dr. Escudé and Daleigh Tallent emphasized that the intersection of prevention, data, and training is where costs are lowered and lives are saved. IntellectAbility sits at that intersection.

Moving Forward

Medicaid funding challenges are real, but so are opportunities to innovate, collaborate, and prevent crises before they happen. By applying these strategies—and using tools like HRST, Academy training, and person-centered planning—providers can protect HCBS, support people with IDD, and stretch every Medicaid dollar further.

Want to learn more?

Supporting Aging People with IDD: Key Insights from Pam Merkle and Dr. Craig Escudé

Supporting Aging People with IDD: Key Insights from Pam Merkle and Dr. Craig Escudé

By Aliah Farley

As life expectancy increases, people with intellectual and developmental disabilities (IDD) are living longer than ever before. This presents both opportunities and challenges for service providers, families, and healthcare professionals.

In a recent IDD Perspectives webinar, Pam Merkle, Executive Director of the Association on Aging with Developmental Disabilities, joined Dr. Craig Escudé, President of IntellectAbility, to discuss the unique issues people with IDD face as they age and practical strategies to help them thrive.

Shared Concerns in Aging

Pam opened the discussion with a powerful reminder: the concerns people with IDD experience as they age are largely the same as those faced by the general population.

Drawing on surveys of adults with IDD, she highlighted the most frequently mentioned worries:

  • Dementia
  • Depression
  • Health problems
  • Loneliness
  • Medication side effects

Underlying many of these issues is the theme of loss, the loss of friends, family, independence, mobility, and sometimes even one’s home or trusted providers. “For people with IDD,” Pam explained, “loss often happens at an accelerated pace and with fewer supports in place.”

A Proactive Approach to Healthy Aging

Too often, services for people with IDD become reactive, addressing crises after they happen. Pam emphasized the importance of taking a proactive approach instead, fostering health, identity, and belonging long before problems arise. This aligns with the concept of healthy aging, which focuses on maintaining functional ability and overall well-being throughout life.

Her “Healthy Recipe for Aging” includes:

  • Exercise and nutrition: supporting physical health through movement and balanced diets. These activities offer significant benefits for maintaining physical abilities and promoting healthy aging.
  • Cognitive stimulation: encouraging brain health through puzzles, memory games, and activities. Cognitive stimulation, along with education, helps preserve cognitive abilities and other skills, supporting cognitive resilience in older adults.
  • Friendship development: building supportive social networks to prevent isolation. Social connection provides benefits for emotional health and helps maintain other skills important for daily living.
  • Identity and reminiscence: affirming who people are through meaningful roles, hobbies, and life stories.
  • Combating loneliness: creating opportunities for connection, purpose, and joy.

Education is a key factor that supports healthy aging and cognitive resilience. In addition to these, other factors such as social and environmental influences also contribute to the aging process and overall health outcomes.

Pam illustrated this with creative programs developed at her agency, such as “Senior Hotshots,” where older adults with IDD can redefine themselves not only by age, but by the unique talents and interests that shape their identities. Through these programs, older adults with IDD can contribute to their communities, sharing their experiences and skills.

The results, she noted, are striking: fewer emergency room visits, improved mental health, and stronger self-esteem. These benefits highlight the positive outcomes of ongoing efforts to promote healthy aging and address the various factors that influence well-being in older adults.

Addressing Dementia and Cognitive Decline

When someone with IDD shows signs of memory loss, Dr. Escudé stressed the need to rule out medical causes first. Identifying risk factors for dementia and cognitive decline in patients with IDD is crucial for early detection and management. “Don’t jump immediately to dementia,” he cautioned. Hearing or vision loss, medication side effects, thyroid conditions, depression, or even untreated pain can mimic dementia. Comprehensive medical care and timely intervention are essential to address these issues and improve outcomes.

Hearing health, in particular, is critical: untreated hearing loss accelerates cognitive decline and contributes to dementia risk. Research shows that dementia and related conditions can significantly affect individuals with IDD, with chronological age and risk factors such as lifestyle and comorbidities playing a major role in disease progression. Conditions originating in childhood, like cerebral palsy or Down syndrome, can also influence the risk of dementia and late effects as people age.

For those with confirmed dementia, consistency is key. Supporters, including nurses, should maintain familiar staff and routines, use memory aids, and provide clear visual cues. Ongoing follow-up care is important to monitor changes and adjust interventions as needed. Dementia is a leading cause of mortality among older adults with IDD, highlighting the importance of early intervention and continuous support for these patients. Screening tools from the National Task Group on Intellectual Disabilities and Dementia Practices (NTG) can also help identify changes early.

Supporting Mental Health and Depression

Distinguishing between temporary sadness and clinical depression is essential. Both Pam and Craig emphasized the need to assess physical and emotional health together. A sudden withdrawal, for example, could indicate anything from grief to untreated illness.

Therapy and medication may play a role, but so do trauma-informed supports: creating safe environments, building connection, and giving people meaningful choices in their daily lives.

Promoting Health Through Preventive Care

Preventive healthcare remains one of the greatest unmet needs for people with IDD.

Pam urged providers to ensure that aging adults receive routine screenings—such as mammograms, prostate exams, and colonoscopies—that are often overlooked in this population. It is essential to provide timely follow-up to ensure patients complete necessary preventive care and remain engaged in ongoing health management. Supporters must also navigate the risks of polypharmacy: once someone is on five or more medications, the chance of dangerous interactions rises significantly.

Advocates play a vital role in bridging the gap between medical professionals and people with IDD, supporting patients and helping to manage their healthcare needs. Staff who can “translate” complex medical language, track symptoms, and prepare questions for doctors help ensure people get the quality healthcare they deserve.

Ongoing efforts are needed to manage risk factors, late effects, and secondary disorders through continuous medical care and timely intervention, aligning preventive care with World Health Organization guidelines and research-based best practices. The safety of healthcare settings is paramount, and legal acts such as the Act on Guarantee of Right to Health and Access to Medical Services for People with Disabilities help ensure access to medical care for people with IDD.

Housing and Transitions

Affordable housing was another pressing issue discussed in the webinar. Pam explained that some people lose housing support after decades, particularly when HUD-backed arrangements expire. Families and providers must plan early for transitions, always seeking the least restrictive and most person-centered living arrangement possible.

When moves are necessary, familiarity matters. Keeping routines, personal items, and trusted staff in place can soften the disruption and preserve a sense of stability.

Coping with Loss

As people with IDD age, loss becomes a recurring reality—whether it is the passing of parents, peers, or longtime staff.

Friendship development programs and reminiscence activities can provide vital comfort and continuity. Equally important is giving people the opportunity to grieve openly, with the same compassion and validation anyone else would receive.

Takeaways for Supporters

The conversation closed with practical reminders for families, staff, and providers:

  • Be proactive. Don’t wait for crises. Focus on prevention, screenings, and healthy routines.
  • Support identity. Help people maintain meaningful roles and relationships, and encourage them to participate actively in their communities and decision-making.
  • Build friendships. Encourage connections that protect against isolation.
  • Advocate for healthcare. Ensure providers understand the unique needs of people with IDD.
  • Meet people where they are. Individualized support makes the biggest difference.

Conclusion

Aging is a universal experience, but for people with IDD, it comes with added challenges, often compounded by limited resources and systemic barriers. Yet as Pam Merkle and Dr. Craig Escudé emphasized, with the right supports in place, people with IDD can age with dignity, health, and fulfillment.

Their message is clear: the best outcomes come from proactive, person-centered strategies that honor identity, strengthen community, and ensure access to quality healthcare.

For more resources, including practical guides and healthcare spending in IDD, visit IntellectAbility’s website or explore the full IDD Perspectives webinar series.

10 Strategies to Optimize HCBS Spending and Improve Outcomes

10 Strategies to Optimize HCBS Spending and Improve Outcomes

By Aliah Farley

Medicaid-funded home- and community-based services (HCBS) are at a crossroads. Demand continues to grow as more people with intellectual and developmental disabilities (IDD), older adults, and people with physical disabilities seek support in their homes and communities. Yet funding is strained, costs keep rising, and the workforce is stretched thin.

What Are Intellectual and Developmental Disabilities (IDD)?

Intellectual and developmental disabilities are characterized by significant limitations in intellectual functioning and adaptive behavior, which includes everyday social and life skills. These disorders are typically present at birth or early childhood, and intellectual disability starts before a child turns 18. Such conditions can affect multiple body parts and the person’s physical and cognitive abilities, impacting their ability to learn, reason, and develop other skills.

Examples of developmental disabilities include cerebral palsy, autism, and Down syndrome. In many cases, other disabilities or disorders may be present alongside intellectual disabilities, reflecting the broader category of developmental disabilities.

How Is HCBS Eligibility Determined for People with IDD?

To describe situations where these conditions overlap, it is important to recognize that eligibility for HCBS programs is determined by factors such as age, income, and disability status. Most programs are designed to help people qualify for and access a wider range of benefits and services, supporting people across different ages. Income thresholds are often used to determine who is eligible.

The challenge is not simply how to spend less, but how to spend smarter—using resources where they have the most impact while ensuring people receive the highest quality of support.

The good news is that proven strategies help Medicaid programs and HCBS providers achieve this balance. By focusing on prevention, smarter data use, workforce investment, and person-centered approaches, agencies can reduce costly crises, improve outcomes, and protect limited resources.

Below are 10 strategies to optimize HCBS spending and improve outcomes—with insights into how IntellectAbility’s tools and training can support success.

10 Strategies to Optimize HCBS Spending & Improve Outcomes

1. Focus on Prevention

The most effective way to reduce costs is to prevent avoidable health crises. Emergency room visits and hospitalizations are not only expensive, they disrupt people’s lives.

Prevention starts with identifying risks early. IntellectAbility’s Health Risk Screening Tool (HRST) flags subtle changes in health, behavior, or mobility that often precede emergencies. Early identification helps people with intellectual and developmental disabilities by ensuring they receive timely assistance and support tailored to their needs. Routine screenings, vaccinations, and chronic condition management keep small problems from escalating. And when staff are trained to notice early signs of decline, interventions can happen before a crisis hits.

The result: fewer hospitalizations, better quality of life, and lower costs.

2. Use Data and Predictive Tools

Medicaid leaders and providers need more than historical claims data—they need actionable insights. By combining claims information with real-time risk data from tools like the HRST, agencies can identify who is most at risk and act before costs spiral.

Predictive analytics and data dashboards make it possible to forecast needs and allocate resources more effectively. For example, if data shows a cluster of people at risk for aspiration pneumonia, staff can be trained, and preventive supports can be put in place before costly hospitalizations occur. These data-driven approaches ensure resources are allocated efficiently to manage support models, which coordinate services and help control costs.

Data isn’t just about reporting—it’s about guiding smarter, proactive decisions that help agencies pay for the right services at the right time.

3. Improve Care Coordination

When support is fragmented, outcomes suffer. People with IDD often see multiple providers across medical, behavioral, and social services. Without coordination, supports can overlap, get missed, or conflict. Supporters—both family and friends—play a vital role in ensuring coordinated care.

That’s why assigning support coordinators with IDD-specific expertise is critical. Even better, Person-Centered Thinking (PCT) Training equips staff to align services with each person’s goals, preferences, and strengths, empowering people and supporters to decide on the best care options. By putting the person at the center, agencies not only improve engagement and satisfaction but also reduce costly reactive care.

Strong interdisciplinary teams, supported by clear communication tools like HRST profiles, ensure nothing falls through the cracks.

4. Use Technology Wisely

Smart technology is a game-changer for HCBS efficiency. Telehealth expands access to behavioral health and follow-up appointments, while remote monitoring tools help keep people with complex medical needs safe at home.

Automation also reduces administrative burden. For example, the HRST integrates medication and diagnosis data automatically, saving staff time and improving accuracy. Technology should never replace human support, but when used wisely, it frees staff to focus on what matters most: direct, person-centered support.

5. Shift to Value-Based Payment

Traditional fee-for-service models reward volume, not value. The future lies in value-based payment (VBP), which ties funding to outcomes like fewer hospitalizations, better preventive support, and improved quality of life. Value-based models can also align Medicaid services and Medicare funding, improving outcomes and efficiency for those who may be covered by both programs.

Agencies that adopt VBP models must demonstrate measurable results. Tools like the HRST provide quantifiable health risk data, while PCT ensures staff practices align with person-centered goals. Together, these resources provide the evidence funders need to justify continued investment.

By focusing on outcomes instead of units of service, states and agencies can maximize both cost-effectiveness and quality.

6. Strengthen and Retain the Workforce

The HCBS workforce is the backbone of community support—but high turnover and burnout drain resources and disrupt support. Investing in training, recognition, and career development is not optional; it’s essential. Training staff to support employment opportunities, such as supported employment for people with disabilities, and to provide personal care services, is crucial for meeting the diverse needs of those served.

IntellectAbility’s Academy offers scalable, accredited training that equips Direct Support Professionals (DSPs), nurses, and case managers with practical, person-centered, and clinical skills. PCT training helps staff feel more confident and connected to their work, reducing stress and burnout.

By creating career ladders, offering mentorship, and recognizing achievements, agencies can retain skilled workers who deliver consistent, high-quality support.

7. Reduce Use of High-Cost Settings with Community-Based Services

When preventive support fails, people oftenrequire care in costly institutions or hospitals. Facility-based support can be necessary, but supporting people in their own homes through community-based services and home options offers significant benefits. These programs help people avoid more restrictive settings and maintain independence.

Tools like the HRST flag emerging risks so agencies can act quickly, keeping people safely in their own homes. Crisis stabilization services in community settings provide alternatives to hospitalization, and transition planning reduces reliance on restrictive support.

Not only does this save money, but it also allows people to remain in the environments where they thrive.

8. Address Social Determinants of Health (SDOH) for People with Intellectual and Developmental Disabilities

Health isn’t shaped by medical care alone. Housing, food security, transportation, and social ineteraction play enormous roles in outcomes. HCBS programs address multiple categories of need related to these social determinants, ensuring a comprehensive approach. National programs, such as CMS’s specialized initiatives like the Program of All-Inclusive Care for the Elderly (PACE) and the Money Follows the Person (MFP) Rebalancing Demonstration Grant, also play a significant role in supporting these efforts.

HCBS programs can use Medicaid flexibilities to fund non-clinical supports, closing service gaps that drive costly emergencies. The HRST and PCT Training also help identify environmental and social risk factors that might otherwise be overlooked.

Partnering with community organizations ensures people have the basics they need to stay healthy, safe, and engaged in their communities.

9. Cut Inefficiencies

Every dollar wasted is a dollar not spent on improving lives. Agencies can reduce inefficiencies by conducting utilization reviews, eliminating duplicative services, and aligning provider payment rates with actual needs. Reviewing different provider types and different types of services helps identify and eliminate inefficiencies across support settings.

Clinical decision tools, informed by HRST data, guide smarter resource allocation. Automated documentation reduces errors and saves staff time. By regularly reviewing processes, agencies can prevent waste and reinvest savings into better supports.

Efficiency isn’t about cutting corners—it’s about making sure resources flow to where they matter most.

10. Involve People and Families

The people receiving services—and their families—are the experts in their own lives. Involving them in planning leads to better outcomes and increased satisfaction. Family members play an important role in advocating for and planning a wider range of service options, ensuring that supports are flexible and responsive to individual needs.

Person-Centered Thinking Training gives staff the skills to listen deeply and honor what matters most to each person. Supported decision-making empowers people to direct their own lives, reducing unnecessary guardianship.

When people and families are true partners, services align with their goals, strengths, and preferences. This is both person-centered and cost-effective because supports are more likely to succeed.

Final Thoughts

Optimizing HCBS spending is about more than saving money. It’s about ensuring that every dollar goes toward supports that truly improve lives. By focusing on prevention, data-driven support, workforce development, and person-centered approaches, agencies can reduce costs while enhancing outcomes.

IntellectAbility is proud to partner with states and provider agencies on this journey. Our tools—HRST for early risk detection, PCT Training for person-centered practices, and the Academy for workforce training—equip agencies to succeed even in budget cuts.

The choice is clear: continue with reactive, fragmented support, or adopt proactive, person-centered, value-focused strategies. The tools exist. The need is urgent. The time to act is now.

Download our full white paper, “Optimizing HCBS and Healthcare Spending for People with IDD During Medicaid Cuts,” to dive deeper into these strategies.

IDD Smarter Spending, Better Outcomes: How States Can Optimize HCBS with IntellectAbility

IDD Smarter Spending, Better Outcomes: How States Can Optimize HCBS with IntellectAbility

By Aliah Farley

Medicaid programs across the country face a familiar challenge: rising demand, finite budgets, and a system too often forced into crisis response. The question isn’t whether states can keep spending more, it’s whether they can spend smarter.

That’s where home- and community-based services (HCBS) come in.

HCBS programs provide services through various agencies and providers, improving access to support for people with intellectual and developmental disabilities (IDD). HCBS has proven to be cost-effective and person-centered, but without strategic shifts in funding and measurable outcomes, states risk pouring dollars into preventable emergencies rather than proactive support, missing the opportunity to positively impact people with IDD and their communities.

More on Intellectual and Developmental Disabilities

Intellectual and developmental disabilities (IDD) are a broader category of lifelong conditions that are present from birth or early childhood and affect a person’s physical, intellectual, and emotional development.

Intellectual disability starts before age 18 and is characterized by limitations in intellectual functioning—such as intelligence, reasoning, problem solving, and other skills—and adaptive behavior, which includes everyday social skills, and other skills needed for daily living.

These disabilities can affect multiple body systems and impact communication, eating, and social interaction skills. Examples of intellectual or developmental disabilities include autism, cerebral palsy, spina bifida, hearing disorders, and other disabilities and disorders.

Prevention That Pays Off

For people with intellectual and developmental disabilities (IDD), hospitalizations are costly and disruptive. IntellectAbility’s Health Risk Screening Tool (HRST) empowers states and agencies to identify medical risks early, flagging subtle changes in health before they escalate into expensive hospitalizations.

By implementing the HRST across HCBS programs, states can reduce unnecessary costs while improving support quality. Early detection doesn’t just save money; it strengthens the system for providers and, most importantly, the people receiving support.

Data-Driven Decision Making

Medicaid leaders need more than historical claims; they need actionable insights.

With HRST, agencies can aggregate risk data to predict potential crises, enabling states to target interventions where they’ll have the most significant impact. This data helps in situations where patients may require specific treatments or interventions, supporting more precise and effective support.

Combined with Person-Centered Thinking (PCT) Training, staff are equipped to act on this data thoughtfully, ensuring support aligns with the person’s needs while maximizing efficiency. A clear understanding of the data allows agencies to allocate resources more effectively and improve outcomes.

Together, the HRST and PCT Training provide a comprehensive framework for informed, outcome-driven decision-making.

Value-Based Funding That Works

Fee-for-service models reward volume, not outcomes, whereas value-based funding aims to improve outcomes for persons with disabilities by focusing on measurable progress and individual rights.

IntellectAbility’s tools support a shift to value-based support by connecting risk detection, workforce training, and person-centered planning with quantifiable health and quality of life improvements. They help address discrimination and support equitable systems in compliance with relevant law.

Key outcomes states can track for intellectual and developmental disabilities include:

  • Reduced avoidable ER visits and hospitalizations
  • Increased preventive care compliance
  • Enhanced person-centered outcomes

These outcomes have positively affected people with IDD, allowing them to experience better health and greater independence.

When funding models reward prevention and stability, everyone benefits: the system, the providers, and the people served.

Building Efficiency Across the Community-Based Services System

Workforce shortages, high turnover, and administrative burdens drive costs up.

IntellectAbility’s Academy provides scalable, accredited training to upskill direct support professionals (DSPs) and agency staff, reducing variability in support delivery. The training is delivered in partnership with centers and institutions to assist staff in providing high-quality support. The Academy offers a variety of training materials and resources to support ongoing staff development. Combined with PCT, this strengthens staff capabilities, reduces burnout, and ensures consistent, high-quality services.

States that leverage the HRST, PCT Training, and the Academy in their community-based services can streamline operations, better use limited funds, and reinforce a culture of proactive support.

Rethinking Medicaid Strategy

Spending smarter doesn’t mean cutting corners.

By integrating the HRST for risk detection, PCT Training for workforce development, and the Academy for scalable training, states can drive better health outcomes, reduce costs, and strengthen the HCBS system for the future. Medicaid strategies must address the needs of people with disabilities due to injuries, age, and other conditions, ensuring that healthy outcomes remain the ultimate goal.

Read more about these strategies and how IntellectAbility can help in our newest white paper, Optimizing HCBS and Healthcare Spending for People with IDD During Medicaid Cuts, which also considers world best practices and the role of organizations like the Social Security Administration in defining disability.