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Elizabeth M. Whitehorn, Director

Roll-Out by Health Plans

March 2014

  • Illinois Health Connect (IHC)

    • Primary Care Case Management (PCCM) Program - outside mandatory managed care regions

  • Seniors and Persons with Disabilities (SPD)

      • Disabilities (SPD) - in mandatory managed care regions

    • Integrated Care Program (ICP)

        • Demo Area - Suburban Cook/Collar - May 2011

      • Mandatory Managed Care Expansion

        • Rockford (Aetna, IlliniCare, (CCAI) - July 2013 (SP 1 and 2)

        • Central IL (Molina, Meridian, Health Alliance, Macon County (CCE) - September 2013 (SP 1 and 2)

        • Metro East (Molina, Meridian) - September 2013 (SP 1 and 2)

        • Quad Cities (IlliniCare, Precedence CCE) - November 2013 (SP 1and 2)

        • Chicago (Greater Chicago MMAI plans & CCAI) - Expand to - Cook March 2014, Collar July 2014

    • Medicare Medicaid Alignment Initiative (MMAI)

        • March 2014 - voluntary enrollment

        • June 2014 - mandatory enrollment

      • MCOs

          • Greater Chicago Area

            • Aetna Better Health

            • Illini Health Plan

            • Meridian Health Plan of Illinois

            • HealthSpring of Illinois

            • Humana Health Plan

            • Blue Cross/Blue Shield of Illinois

          • Central Illinois

            • Molina Healthcare

            • Health Alliance Medical Plans

          • Managed Long Term Supports and Services (MLTSS) - All MMAI Plans

      • Care Coordination Innovations Projects

        • 6 awarded (4 in Chicago area, 2 downstate) and additional projects statewide as they become available

          • CCEs (5)

              • Be Well Partners in Health (Chicago area) - February 2014

              • EntireCare - Healthcare Consortium of Illinois (Chicago area) - February 2014

              • My Health Care Coordination - Macon County (down state) - September 2013

              • Precedence Care Coordination (downstate) - October 2013

              • Together4Health (Chicago area) - February 2014

            • Medical Home Network (MHN)

      • MCCNs (1)

        • Community Care Alliance of Illinois (CCAI) = Subsidary of Family Health Network

          • Rockford - July 2013

          • Chicago only - March 2014

          • Collar Counties - July 2014

  • Children with Complex Health Needs (CCEs)

      • Statewide (growth based on capacity) - July 2014*

    • CCMN/CCEs

      • Lurie Children's Hospital - CCE

      • La Rabida - CCE

      • OSF - CCE

  • Children/family and Caregivers

      • In mandatory managed care regions - July 2014

    • Accountable Care Entities

      • Accountable Care Entities (some to begin in July 2014)

      • MCOs - Same regions as ICP, same MCOs as MMAI, plus Harmony and Family Health Network (FHN)

  • Newly Eligible Adults Under ACA (Adults 19 - 64)

      • in mandatory managed care regions - January 2014, all counties except Cook

      • July 2014, Cook County

    • Accountable Care Entities

      • Accountable Care Entities (some to begin in July 2014)

      • MCOs - Same regions as ICP, same MCOs as MMAI, plus Harmony and Family Health Network (FHN)

    • County Care (Cook County Only)

      • Cook County Waiver - First Enrollment - November 2012, June 2014

      • County Care MCCN: July 2014 (May serve SPD and Children/families)

Types of Managed Care Entities

  • MCOs - Accepting full-risk capitation payments

  • MCCNs - Provider-organized entities accepting full-risk capitation payments

  • CCEs - Provider organized netwokrs providing care coordination

  • ACEs - Provider-organized entities on a three-year path to full-risk capitation payments

Targeted start dates are in red bold