Essential financial resources include money needed by the initiative in order to serve clients as well as an initial investment of capital necessary to start a large and complex program. The sources of those start-up funds as well as funds for ongoing operations must be identified. Finally, an assessment must be made of how quickly a program can be implemented once it has been designed and approved. State officials must decide whether and how to phase in the effort, based on their assessment of existing capacity at both state and provider levels. Certain critical factors must be addressed in designing balanced managed care alternatives.
Many tools can help to manage care, risk, or both.
Eligible populations must be defined and enrolled in the new system. The nature and size of a population, its service needs, and its experience in service utilization must be estimated and the potential size and cost of the proposed effort projected. Decisions about eligibility will include an analysis of the situation through which the child or family comes to be seen as in need of service, as well as an assessment of the system's capacity to provide the necessary services. Once a population subset has been found to have specific service needs, and after individual and family eligibility has been determined, officials must choose whether and when to enroll them in the managed care initiative. Issues related to enrollment of publicly supported populations differ from and often are more difficult than enrolling commercial populations in managed care.