State Launches Second Phase of Integrated Care Program

CHICAGO – The Illinois Department of Healthcare and Family Services (HFS) today announced the second phase of the state’s Integrated Care Program (ICP) to improve health and quality of life outcomes for seniors and persons with disabilities in the Illinois Medicaid system. Beginning today, long-term services and supports (LTSS), 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 ICP, which was created to keep residents healthy through more-coordinated and better medical care, helping prevent unnecessary healthcare costs.

“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,” HFS Director Julie Hamos said. “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 Governor 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 healthcare 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 healthcare procedures.

The Integrated Care Program is expected to save the state an estimated $200 million over five years, compared to 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. In the second phase of the program announced today, long-term care services will now be included into the service package for eligible Medicaid clients, including nursing home care and home and community based services.

In its second phase, the program will continue to serve nearly 40,000 Medicaid recipients in the 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 persons with developmental disabilities.

This is the state’s first-ever integrated health care program for seniors and persons 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 healthcare 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 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