Overview
There’s a lot of noise about proposed Medicaid cuts—but what does it actually mean for IDD agencies on the ground? In our latest eBook, Projected Medicaid Cuts: What’s Happening—and How to Stay Ahead, we unpack the potential changes coming and what agencies can do to prepare.
Federal cuts
In Chapter 2, we explore what’s currently on the table at the federal level, including a proposal to reduce Medicaid funding by up to $880 billion over the next 10 years. While these cuts don’t specifically target IDD services, they would likely put pressure on state budgets—forcing states to make difficult decisions about waiver funding, eligibility, and reimbursement rates.
That pressure could lead to slower service authorizations, reduced funding availability, and increased scrutiny around documentation and billing accuracy. Even if your agency is doing everything right, your systems need to be ready to prove it.
Redetermination
During the public health emergency, annual redeterminations were paused. Now, they’ve resumed, and many individuals are losing coverage simply because forms weren’t completed or deadlines were missed. Chapter 2 explains how this single process can create weeks of unreimbursed services and unexpected care disruptions.
For agencies, staying ahead of redetermination means tracking renewal dates, keeping families and guardians informed, and assigning internal leads who can follow up before coverage lapses. It’s not just an administrative detail—it’s central to protecting care and reimbursement.
Cost of falling behind
Small issues—like a missed time entry or a late shift note—can snowball into larger financial problems. Chapter 3 walks through the chain reaction that occurs when documentation, billing, and compliance aren’t tightly connected.
Agencies that fall behind often face delayed payments, administrative backlogs, and a greater risk of audit findings. More importantly, individuals may experience gaps in care or lose services they rely on. These consequences don’t happen overnight—but when they hit, they can disrupt everything.
Value-based care
Another growing trend explored in Chapter 2 is the move toward value-based reimbursement. While it hasn’t fully taken hold in the IDD space yet, some states are beginning to explore pilot models. This shift means agencies will need to document not just that services happened, but that they led to measurable progress.
Preparing now means thinking about what data you already have, like goal tracking, satisfaction feedback, or incident reduction—and beginning to use it more intentionally. Agencies that build these habits early will be better positioned when expectations change.
Most gaps go unnoticed
One of the most overlooked risks facing IDD agencies is the kind that doesn’t make noise right away. A missed EVV record or a delay in entering service notes might not seem urgent in the moment, but these small lapses often grow into costly problems over time.
By the time a claim is denied or an audit flags inconsistencies, the fix usually involves hours of backtracking, duplicate work, and stress for everyone involved. What’s more, these issues can erode trust with funders, families, and frontline staff. The sooner you identify potential weak spots in your documentation or workflows, the easier they are to correct—and the more confident your team becomes moving forward.
Want the full guide?
Projected Medicaid Cuts: What’s Happening—and How to Stay Ahead was built specifically for IDD agencies navigating uncertainty. If your team is preparing for Medicaid changes, redetermination, or simply wants to tighten your internal systems, this guide will help you take the right next steps.
Download your copy and explore what’s changing, what’s at risk, and how agencies like yours can stay compliant, confident, and ready for what’s next.
