As states across the country continue to examine the way that DD services are delivered through Medicaid, the concept of managed care continues to gain steam.  In this model, private insurance companies are responsible for administering and funding the health services, managed long term care services and DD home and community based services of an individual.  The state typically turns to a capitated model, where each individual qualifies for a set amount of funds for a year and the insurance company is responsible for providing the services within that individual's set budget.  DD HCBS services are typically foreign to private insurance and this raises red flags for providers in terms of the long term safety of the services they are providing.  Another side effect from managed care is an increased focus on health initiatives for individuals with developmental disabilities.  Because insurance companies are responsible for health services, including doctor visits and emergency room visits, they want to insure that everyone that's covered is living as healthy lives as possible.