A History of Success Helps a Once-Novel Medicaid Option Go Mainstream

Health care is always most effective when it is as personal and precisely targeted as possible. Unfortunately, many doctors and other healthcare professionals have little time today to form close, nurturing relationships with patients.

This might be acceptable when a single surgery or other treatment needs to be carried out, but it is never a suitable basis for longer term arrangements. A Medicaid program has, for nearly two decades, afforded a more personal alternative to disabled people and others.

The Consumer Directed Services (CDS) system has become a widely noted success story, with other organizations and agencies implementing their own equivalents. There are a number of reasons why CDS works so well in practice and so often proves superior to the alternatives.

CDS Puts Patients in Control

Needing to obtain any sort of healthcare can easily leave a person feeling vulnerable and dependent. That generally becomes even more the case when physicians, nurses, and others seem pressed for time and unable to devote a great deal of attention to any one patient.

The approach that gave rise to CDS was detailed in a widely cited 2001 article that appeared in the Health Affairs journal. The author described how individual states had been experimenting with allowing certain Medicaid beneficiaries to take charge of their care and treatment plans.

In practice, that strategy ended up being successful more often than not, despite the skepticism that some had previously expressed. Patients who were allowed to make their own arrangements tended to do so with more precision and specificity than professional case managers and others.

An Important Option for Many Today

As a result, CDS has become well-established in many state-run Medicaid programs and a favorite among beneficiaries nationwide. Far from being free of structure and support, CDS is designed to allow however much freedom patients might want and benefit from.

That built-in flexibility makes CDS appropriate across a wide range of situations. Patients who are allowed to make long-term arrangements regarding their care tend to become productively invested in the process. In the end, that almost always ends up meaning being more satisfied, and often healthier and better accommodated, as well.