Care Plans, Care Teams, and Quality of Life for People with Disabilities

Karen Donelan
Yuchiao Chang
Holly Matulewicz
Kimberly Warsett
Dennis Heaphy
Lisa I. Iezzoni
Peer-Reviewed Article
August 2020


For people with disabilities, familiarity with their care teams and care plans and increased access to long-term services and supports (LTSS) can improve their perceptions of quality of life and health care.


In 2013, Massachusetts launched the One Care program under the Financial Alignment Demonstration. One Care integrates physical health care, behavioral health care, and LTSS for people with disabilities who are dually eligible for Medicare and Medicaid. The program requires contracted health plans to establish individualized care teams and engage patients in their care planning through the development of care plans. In this study, researchers collaborated with people with disabilities to develop a new set of quality measures to assess quality of life, health, and health care of One Care enrollees. The researchers also surveyed a subset of enrollees to understand the impact of this model and how patient engagement in care coordination and planning can lead to improvements in patient perceptions regarding the quality of life and the health care they receive.


During the two-year study, a majority of the One Care enrollees surveyed reported positive changes in measures of their quality of life. More specifically, knowledge of their care plan and care team increased enrollees’ odds of reporting more control over health, improved health care quality, and overall health. Additionally, access to LTSS was positively correlated with perceptions of hope, overall health, and improved quality of care.


The integration of care teams, engagement in care planning, and access to LTSS can lead to positive health outcomes, improved health care quality, and enhanced quality of life for patients who live with significant physical disability or serious mental illness. Health plans and systems should ensure that people with disabilities have a say in their care plans and should consider engaging consumers in quality measure development.

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