State launches 2nd phase of
Integrated Care Program
Long-term care services added to
integrated care delivery system to improve care for seniors and
peoples with disabilities
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[February 02, 2013]
CHICAGO -- On Friday, the
Illinois Department of Healthcare and Family Services announced the
second phase of the state's Integrated Care Program to improve
health and quality-of-life outcomes for seniors and people with
disabilities in the Illinois Medicaid system. Beginning Friday,
long-term services and supports, including nursing home care and
home and community-based care, will now be added to the service
package for the 40,000 individuals currently eligible for the
Integrated Care Program, which was created to keep residents healthy
through more-coordinated and better medical care, helping prevent
unnecessary health care costs.
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"Through the Integrated Care Program, we expect better health outcomes for our
clients, because a network of providers will work in a collaborative fashion to
address the holistic needs of our clients," said HFS Director Julie Hamos. "This
type of coordinated care is essential to meet the complex needs of our most
vulnerable clients. At the same time, it helps increase the efficiency of state
resources and saves taxpayers' money." Delivering on Gov. Pat Quinn's
commitment to move half of Illinois' Medicaid clients into care coordination by
2015, the Integrated Care Program is part of the state's new integrated care
delivery system, designed to bring together local primary-care physicians,
specialists, hospitals, nursing homes and other providers to organize care
around a patient's needs and reduce unnecessary health care costs. Each client
is assigned a care manager to coordinate their care and ensure that the needed
services and supports are provided while avoiding unnecessary health care
procedures.
The Integrated Care Program is expected to save the state an estimated $200
million over five years, compared with costs under the current fee-for-service
delivery system. The savings will be achieved by reducing unnecessary
hospitalizations, emergency room visits and nursing home placements. The program
will also save money by shortening lengths of hospital stays, eliminating
duplicate testing and procedures, and generally improving the overall health of
those enrolled. The contracts will also include provisions to ensure monthly
payments from the state will be used for essential medical and support services.
In the first phase of the program, care coordination was focused on standard
Medicaid medical services, such as physician and specialist care, emergency
care, laboratory and X-rays, pharmacy, mental health and substance abuse
treatment.
In the second phase of the program, announced Friday, long-term care
services, including nursing home care and home and community-based services,
will now be included in the service package for eligible Medicaid clients.
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In its second phase, the program will continue to serve nearly
40,000 Medicaid recipients in suburban Cook, DuPage, Kane, Kankakee,
Lake and Will counties. Selected by HFS in September 2010, Aetna and
Centene-IlliniCare will continue to provide and manage the care for
these recipients. The contracts have pay-for-performance measures
that create an incentive for the companies to spend money on care
that produces valued outcomes -- better health and quality of life
-- while at the same time reducing the cost of the service over
time.
The third phase of ICP is expected to launch in 2014 and will cover
people with developmental disabilities.
This is the state's first-ever integrated health care program for
seniors and people with disabilities in the Medicaid program. The
Integrated Care Program 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 by
2015. The goal is to redesign the health care delivery system so
that it is more patient-centered, with a focus on improved health
outcomes, evidence-based treatments, enhanced patient access and
patient safety.
For more information about the care coordination Innovations
Project, go to
http://www2.illinois.gov/hfs/PublicInvolvement/
cc/Pages/default.aspx.
The full Care Coordination Roll-Out Plan can also be found on the
HFS website at
http://www2.illinois.gov/hfs/
SiteCollectionDocuments/CareCoorPlan.pdf.
[Text from
Illinois
Department of Healthcare and Family Services
file received from
the
Illinois Office of
Communication and Information]
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