The Illinois Department of Healthcare and Family Services (HFS) launched HealthChoice Illinois, a new Medicaid Managed Care program, in January 2018.
The seven health plans operating under HealthChoice are: Blue Cross Blue Shield of Illinois, CountyCare (available only in Cook County), Harmony Health Plan, IlliniCare Health Plan, Meridian Health, Molina Healthcare of Illinois and NextLevel Health (available only in Cook County).
HFS also created a portal for providers to seek support for resolving issues with MCOs for the Medicaid Managed Care transformation.
Healthy Illinois 2021
Healthy Illinois 2021 aims to improve the health of Illinoisans. The State Health Improvement Plan (SHIP) and State Innovation Model (SIM) fall under this program. The objective is to understand the current health status in Illinois and establish health improvement strategies that address the need, identify gaps and engage all aspects of the public health system. Individuals who participate in focus groups, presentations and webinars will be asked to provide feedback on the current state of health and their work related to health improvement.
Behavioral Health Transformation – 1115 Waiver
Illinois’ 1115 Waiver was approved by the Centers for Medicare and Medicaid Services in May 2018. An “1115 waiver” is a contract between the federal and state government that “waives” federal Medicaid requirements to allow a state to implement cost-neutral pilot projects. Illinois’ waiver will bring $1.2B in new investments to implement 10 mental health and substance use disorder pilot programs over the next five years. The pilots have scheduled start dates ranging from July 1, 2018 to July 1, 2020 and include both state-wide and geographic-specific implementation. For more information on the waiver, visit the HFS website and sign up to receive HFS provider notices.
State Plan Amendments
As part of its Health and Human Services Transformation, Illinois received approval for the following amendments to its Medicaid State Plan: Integrated Health Homes, Integrated Assessment and Treatment Planning and Mobile Crisis Response. These initiatives will bring $1.5B in matching federal Medicaid dollars to Illinois over the next five years.
Integrated Health Homes
Integrated Health Homes (IHH) will provide physical, behavioral and social care coordination for all individuals enrolled in Medicaid. IHH providers will receive payment for care coordination on a per member, per month rate and can receive outcomes-based bonus payments. Health homes are not required to provide all services and treatment to all members. The process for providers to enroll as IHHs will begin in September 2018.
Under the IHH program, Medicaid beneficiaries will be assigned to one of four tiers based on their behavioral and physical health needs. Individuals in the top three tiers (an estimated 250,000 individuals) will select or be assigned to a Health Home starting in November 2018 and services will begin January 1, 2019. Beneficiaries can switch their IHH provider or opt out at any time. For more information, visit the HFS website.
Integrated Assessment and Treatment Planning
HFS began rolling out a new behavioral health care service known as Integrated Assessment and Treatment Planning (IATP) on August 1, 2018. This marks the beginning of the transition to the IM-CANS for all behavioral health assessment.
Providers may begin using the IM-CANS after completing the training and certification and must adopt the assessment by January 1, 2019, to be reimbursed for IATP services. For more information, visit HFS’ IATP Frequently Asked Questions.
Mobile Crisis Response
HFS introduced Mobile Crisis Response as a new behavioral health care service on August 1, 2018. MCR is a mobile, focused and time-limited service designed to achieve crisis symptom reduction, stabilization and restoration of the client to the previous level of functioning. Providers must obtain Crisis Services Program Approval from HFS to deliver Mobile Crisis Response services. For more information, visit HFS’ Mobile Crisis Response Frequently Asked Questions.
Learn how repealing the Affordable Care Act would impact Illinois. November 2016
The Henry J. Kaiser Family Foundation published “Profile of Medicare Beneficiaries by Race and Ethnicity: A Chartpack” draws on data and analysis from a variety of sources to profile the Medicare population through the lens of race and ethnicity, life expectancy, demographic characteristics, income and savings, health status and chronic conditions, supplemental coverage, selected measures of access to care and service utilization. March 2016
The College for Behavioral Health Leadership’s report on the compensation for peer-support specialists shows striking differences among the current national structures for these salaries. January 2016
The Henry J. Kaiser Family Foundation published a brief that analyzes long-term services and supports among seniors living in the community. October 2015
The Dismantling of Medicaid shows how managed care has changed the nature of Medicaid. November 2014
HFS shared updated demographic data through April 2014 of the enrolled Medicaid expansion population. June 2014