About the DPI

The availability and delivery of health care and support services for persons with disabilities is, simply, abysmal.  Medicaid and dually-eligible adults with physical disabilities currently experience a fragmented health care delivery system: primary care is non-existent or ineffective; the allocation of critical durable medical equipment and personal assistance resources is anything but individualized and based on need; it is difficult – if not impossible – to find disability-competent clinicians, and thus the goals of health, independence and autonomy are ignored. As a result, preventable hospitalizations, and institutional stays feed unnecessarily high costs.  Because of these failures of care (inherent in the existing system due to systemically flawed regulatory framework and financing methodologies), and because together the three founding programs have a successful track record of some 40 years, we have created the Disability Practice Institute to develop, define, and refine the Disability Care Practice (DCP) model and promote its dissemination and replication of disability-competent care.

The DPI will develop materials and train clinicians to be disability-competent, focusing on preventing avoidable medical complications and intervening when illness or medical conditions threaten. Additionally, we will test and document strategies designed to help office-based staff make appropriate accommodations for the DCP population.

One initial focus will be on developing a performance and outcome-based payment model for primary care physicians. The goal of moving away from FFS payments is not to reduce costs, but rather to emphasize performance and outcomes through aligned payments. The existing DCP programs will serve as provider-payment laboratories. As options are identified, we will work with providers to refine the methodology and transition to the alternative payment.