HealthChoice Illinois ADT

The Illinois Department of Healthcare and Family Services launched a statewide data exchange platform in 2021 that delivers vital information to Illinois Medicaid providers in a timely and secure manner. The first phase of the platform enables admission, discharge, and transfer (ADT) alerts to be shared with Medicaid providers whose patients visit a hospital, emergency department, or long term care facility. Future phases will enable sharing other types of data to support the goals of HFS’ Comprehensive Medical Programs Quality Strategy.

The platform sends real-time exchange of ADT notifications from the admitting or discharging facility to a patient’s care coordinator or primary care provider. The result: Improved care coordination, higher quality care, and more successful outcomes.

As part of the Department’s commitment to making this ADT system successful, full Medicaid sponsorship and technical assistance are available to hospitals and other providers for onboarding to the platform and using the data to improve care decisions.

HFS selected PointClickCare (PCC) (previously known as Collective Medical Technologies (CMT)), through competitive bid, to implement the HFS HealthChoice Illinois ADT platform. PCC is one of the largest care collaboration networks in the United States with 70% market share across 27,000+ long term care facilities, 2,700+ hospitals, 2,000+ Ambulatory, 180+ Health Plans, 75+ State & Government Agencies, 370+ ACOs & at-risk providers, and 46 connected networks across the country

The agency has onboarded all managed care organizations within the State.  Hospitals have been the initial source of ADT event notification data. The majority of skilled nursing facilities, that have technology systems capable of sending data in the required format, are also a source of ADT event notifications.

All MCOs, Hospitals, Skilled Nursing Facilities (SNF), Supportive Living Facilities (SLF), Intermediate Care Facilities for individuals with intellectual disabilities/mental retardation (ICF/MR), Specialized Mental Health Rehabilitation Facilities (SMHRF), Federally Qualified Health Centers (FQHCs), Community Mental Health Centers (CMHCs), Behavioral Health Clinics (BHCs), and Substance Use, Prevention and Recovery (SUPR) providers enrolled in the IMPACT system and engaged in direct patient care or providing services to Medicaid customers providers are required to connect to the platform. Other providers are highly encouraged to connect as the agency is working toward full provider participation to increase care coordination and improve Managed Care Organization (MCO) P4P (pay-for-performance) metrics to increase Medicaid customers HEDIS measures established by the National Committee for Quality Assurance (NCQA). 

Pursuant to Federal CMS Interoperability and Patient Access Final Rule, all hospitals, including psychiatric and critical access hospitals, with EHR systems capable of doing so, must send electronic event notifications of admissions and discharges to/from the emergency department and inpatient units to providers responsible for the patient’s treatment or care coordination. The HFS HealthChoice Illinois’ ADT system aligns with the CMS requirements under this federal rule. 

In addition, Illinois’ Comprehensive Medical Programs Quality Strategy includes goals for improving care coordination, using evidence-based interventions to reduce health disparities, deploying technology, and increasing data integration.  The HFS Healthchoice Illinois ADT system is the technology platform that directly supports those critical quality goals and leverages best practices for sharing timely information to enable effective care coordination. 

We continue to ask stakeholders to help us develop additional use cases and data exchange functions that will be beneficial to Medicaid members, including the ability to exchange other types of standardized messages and care plans. We look forward to comments and input.

HFS will be further reaching out through online notices and discussions with providers to keep developing the best and most impactful uses of the ADT platform and to determine the most effective applications for ADT data in emerging value-based payment arrangements.

Please email HFS with comments or to receive additional information.

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