Abstract
Managed care delivery systems seem to be one of the primary vehicles that policymakers have selected to control the accelerating costs of public programs, including services to persons with developmental disabilities. The article provides a case example of a Colorado managed care organization that developed a performance-based funding system to improve supported employment services for individuals with developmental disabilities. The presence of achieved outcomes and quality indicators led to additional funding of service agencies. Contractors were given incentives for reaching certain milestones, such as job placement and job stabilization. To strengthen the milestone system, a three-day intensive skill-building training program was developed for the staff of service agencies to become or enhance skills as supported employment consultants. Service agencies with trained staff could bill at a higher rate for their services. Over a period of 3 years, this payment system led to a 37% in the number of long-term job placements in the community.