Ms Vescovo, who argues that California's payment cuts would eviscerate her clients' access to services, worries that under managed care the disabled might not be able to see the specialists they need.
So, along came managed care, as well as a jumble of other cost-tamping innovations, including high-deductible plans and health-savings accounts.
Will my insurance company, Medicaid, or managed care plan cover these costs?
Advocates of managed care have high expectations.
Many want to place more Medicaid beneficiaries in managed care, which limits access to certain doctors and treatments.
Doctors and nurses are overloaded, and in these days of managed care, you're lucky if you see the same doctor twice.
If states do not draft their contracts properly, or fail to be vigilant in monitoring patients' health, their experiment in managed care could be a disaster.