"This federal approval represents a major step forward for our
efforts to transform Illinois' Medicaid system from a program that
simply pays medical bills, to a wellness system," said Gov. Pat
Quinn. "By aligning these two programs, we will provide seamless,
coordinated care and create an incentive for health care providers
to do a better job of keeping people healthy and treating them when
they become sick."
Illinois is only the fourth state to launch a financial alignment
demonstration with CMS to coordinate care delivery across primary,
acute, behavioral health, prescription drug, and long-term supports
and services, to better serve Medicare-Medicaid enrollees. The MMAI
project is a key component in the state's efforts to move half of
Illinois' Medicaid clients into care coordination by 2015.
"We are pleased to be among a select few states to gain approval
from federal CMS for our plan to provide more coordinated care to
some of our state's most fragile citizens," said HFS Director Julie
Hamos. "It is critical to make sure that Medicare and Medicaid are
working together in concert, and this joint initiative will provide
better care and achieve better outcomes while lowering costs for a
segment of the population who need the most care."
"The partnership with Illinois will help beneficiaries receive
better, more coordinated care and will improve health outcomes,"
said acting CMS Administrator Marilyn Tavenner on Friday. "Today's
announcement demonstrates the state's commitment to improving health
care for Illinois seniors and people with disabilities."
Under the MMAI, the state and CMS will enter into three-way
contracts with health plans that will be responsible for the
provision of all Medicare and Medicaid services afforded to
individuals eligible for both programs. The state estimates that
more than 135,000 seniors and adults with disabilities will be
eligible for care under the MMAI program. Dual-eligibles account for
a high proportion of spending in Medicaid. In 2010, for example,
dual-eligibles made up approximately 9 percent of the population and
27 percent of the costs of the program.
[to top of second column]
In November 2011, the state announced that the following six
entities will serve MMAI clients in the greater Chicago area: Aetna
Better Health, IlliniCare Health Plan (Centene), Meridian Health
Plan of Illinois, HealthSpring of Tennessee Inc. d/b/a HealthSpring
of Illinois, Humana Health Plan Inc., and Health Care Service Corp.
d/b/a Blue Cross/Blue Shield of Illinois.
The clients in central Illinois -- consisting of Knox, Peoria,
Tazewell, McLean, Logan, DeWitt, Sangamon, Macon, Christian, Piatt,
Champaign, Vermilion, Ford, Menard and Stark counties -- will be
served by Molina Healthcare of Illinois and Health Alliance.
The MMAI is one of several initiatives the state is employing to
meet the requirements of the state's 2011 Medicaid reform law to
enroll 50 percent of clients into care coordination. The goal is to
redesign the health care delivery system so that it is more
patient-centered, with a focus on improved health outcomes and
evidence-based treatments, enhanced patient access and patient
For more information about the MMAI, go to
For more information about and to access the MMAI Memorandum of
Understanding between CMS and Illinois, go to
For more information about the Care Coordination Innovations
Project, go to
Department of Healthcare and Family Services
file received from
Illinois Office of
Communication and Information]