Managing services for individuals with intellectual and developmental disabilities (I/DD) has never been more complex or more essential. As states and managed care organizations modernize their I/DD systems, the focus is shifting from administrative oversight to integrated, person-centered care powered by data and technology.
But this next chapter isn’t only about efficiency. It’s about dignity, inclusion, and equity—ensuring that people with I/DD can live full lives in their communities, supported by systems designed for them. Technology plays a critical role: connecting health, home, community supports, and social determinants, while giving the workforce the tools they need to deliver consistent, person-centered care that supports independence.
At the same time, new federal mandates such as the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) are raising expectations for transparency, automation, and real-time data exchange. To stay ahead, I/DD organizations need technology that is not just compliant, but also transformative.
Below is a framework outlining what a next-generation I/DD technology platform must deliver to support members, providers, and payers alike.
Page Content
1. Person-Centered Care and Service Planning
Modern systems must enable comprehensive, person-centered planning, from assessments and Individualized Support Plans (ISPs) to measurable goals and outcomes. Configurable templates, interdisciplinary collaboration, and digital signatures help care teams, guardians, and families align around shared goals with full transparency and audit history.
2. Care Coordination Across Programs and Populations
Effective coordination means breaking down silos between Medicaid, HCBS waivers, Medicare services, and community supports. A unified system integrates medical, behavioral, long-term supports, and SDOH needs into one plan of care. Automated alerts for reassessments, transitions, unmet needs, and service gaps help ensure no member falls through the cracks.
3. Authorizations, Utilization, and Claims Management
Authorizations are central to managing I/DD populations, particularly under waiver and managed care models. A unified platform should automate workflows, validate medical necessity, and link authorizations to claims for reconciliation and audit readiness. Modern systems must also support:
- Claims intake, adjudication, and payment
- Encounter generation and state/federal reporting
- FHIR-based APIs and ePA compliance under CMS-0057-F
By connecting clinical and administrative data, organizations strengthen accuracy, compliance, and payment integrity.
4. Analytics, Reporting, and Value-Based Performance
Accountability in I/DD programs means turning data into insight. Modern systems must provide real-time dashboards, configurable reports, and predictive analytics to help monitor outcomes, equity, service utilization, risk, and cost trends. By enabling data-driven decision-making, these capabilities prepare organizations for value-based and 1115 waiver models, where quality of life, inclusion, and outcomes matter as much as compliance.
5. Provider Network and Workforce Enablement
I/DD providers are the backbone of the system. Technology must support them rather than burden them. A modern platform should include:
- Provider contracting, network management, and accurate service directory maintenance
- Provider self-service portal offering access to authorizations, claims, service plans, documentation, and real-time status tracking
- Simple documentation workflows and streamlined tracking of delivered services
- Tools to reduce administrative burden for DSPs, case managers, and clinical staff
By reducing administrative friction, organizations can help sustain a stable, engaged workforce focused on care rather than paperwork.
6. Administrative Operations and Compliance
Modern I/DD operations require a unified, audit-ready platform that streamlines administrative tasks across programs. This includes:
- Member enrollment, eligibility, and benefit management
- Rules-based benefit and service configuration
- Role-based security, HIPAA, MARS-E, 42 CFR Part 2 safeguards
- Configurable incident, grievance, and regulatory workflows
Integration with MMIS and eligibility systems ensures accuracy and compliance across funding sources.
7. Integration and Interoperability
True whole-person care depends on interoperability. Future-ready platforms must support:
- HL7® FHIR® APIs
- Exchanges with HIEs, social care networks, and state systems
- Provider and Patient Access API compliance
- Data sharing across medical, behavioral, LTSS/HCBS, and SDOH providers
This ensures the right data reaches the right team when it’s needed most, while satisfying CMS’s Provider and Patient Access API requirements.
8. Member, Family, and Guardian Engagement
Empowering individuals and families is vital to inclusion. Secure portals provide access to care plans, service summaries, and outcomes tracking, while digital consent and communication tools foster trust and shared decision-making. Accessibility standards like WCAG 2.1 AA ensure that technology works for everyone.
9. Scalability, Flexibility, and Future-Readiness
As I/DD systems evolve, technology must evolve with them. Tools built for today’s needs must also adapt to tomorrow’s: supporting new waiver structures, integrating emerging services, and scaling across state and provider networks. Future-ready solutions should make it easier to reconfigure workflows, automate updates, and align with changing regulations without disruption.
10. The Role of AI and Predictive Intelligence in I/DD Care
The next generation of I/DD care management will depend on AI and predictive analytics to anticipate needs before crises occur. These capabilities help identify early risk indicators, such as hospitalization patterns or unmet service needs, enabling proactive interventions and more efficient resource allocation. By combining human insight with intelligent automation, the future of I/DD care can be both compassionate and data-driven, empowering people, supporting caregivers, and sustaining community living.
The Path Forward
Technology alone won’t fix systemic challenges, but it can remove many of the barriers that stand in the way of equitable, person-centered care.
At InfoMC, we’re building on the vision of whole-person I/DD care with our Incedo platform, combining AI, automation, and scalable design to help organizations anticipate needs, streamline operations, and connect data, providers, and programs in one unified ecosystem.
The goal: To empower teams to deliver proactive, data-informed care while keeping dignity, inclusion, and independence at the center of every decision.
