Recent Blog Articles
IAMHP is excited to have kicked off another season of our Sam Says podcast. As we welcomed our CEO, the Sam in Sam says, back from maternity leave, we also took time to set the scene for what’s to come this year.
From new staff and tiny additions to the IAMHP family to the start of legislative session and unpacking new policies and their impact on the Medicaid program in Illinois, we are excited to share all that’s to come in what will surely prove to be a jam packed year.
We are grateful to our partners and collaborators for helping us highlight some important topics that we hope you enjoy!
As always, be well and stay safe.
The IAMHP Team
Sam Says is back! In this first episode of 2022, IAMHP introduces two of its newest team members and sets the scene for what's to come for the association in the new year.
In this episode, Sam sits down with Laura Minzer, President of Illinois Life & Health Insurance Council, to discuss insurance policy in the age of COVID.
Legislative Session Kickoff
In this episode, Sam talks with Kareem Kenyatta, IAMHP Legislative Consultant, about what we might expect from the upcoming Illinois Legislative Session.
Setting the Policy Scene for 2022
Sam sits down with Jill Hayden, Director at Sellers Dorsey, to discuss some of the most prevalent topics that will comprise the Illinois healthcare legislative policy landscape for 2022.
The Ambulatory Carve Out - What it Means for Non-Emergency Transportation and Managed Care
Sam sits down with Phil Stalboerger, VP of Public Affairs for MTM (an IAMHP Trusted Partner), to discuss non-emergency medical transportation and changes for Medicaid members due to Illinois House Bill #684.
Want to learn more about how becoming an IAMHP Trusted Partner may benefit your business? Visit our website at: https://iamhp.net/trusted-partner-program.
To stay up-to-date with the latest insights, visit iamhp.net, and be sure to follow us on Facebook, Twitter, LinkedIn and YouTube.
Staying healthy during the holidays is a top priority. This month, IAMHP focused on various areas of healthcare. From vaccines and self-care, to addressing secondary prevention in diabetes in recognition of National Diabetes Awareness Month, to solutions for improving member care, we’ve been just as busy as this holiday season has already proven to be. However, we know how important health is now, more than ever, so we are grateful to our partners and collaborators for helping us highlight some important topics and we hope you enjoy.
As always, be well and stay safe - and Happy Holidays!
This month, IAMHP joined Trusted Partner VaxCare for a webinar on Sharpening Your Vaccine Program: Proven Methods and Tools to Help Keep Costs Down. Vaccines are a cornerstone of preventative care, but they are expensive and time-consuming. Capital outlays for vaccine inventory can often come in second to labor, nurses can spend up to 30 minutes per day on administrative tasks alone, and errors are difficult to recoup. Senior Medical Director at VaxCare, Ralph Weubker, provided guidance on the key behaviors and processes to make vaccine management more efficient and profitable while outlining key items that successful practices use to measure, track and benchmark their vaccine program management.
You can view the webinar via the link below:
Sara Howe, Senior Director at Third Horizon Strategies joined IAMHP CEO, Samantha Olds Frey, to discuss wellness, self-care and handling change during the holiday season.
Electronic Visits Verification (EVV) and Improving Member Care
In this episode, Samantha sits down with Lisa Dugan, Senior Director of Government Relations & Channel Partnering at HHaExchange, to discuss Electronic Visit Verification (EVV) and how it can be used to improve member care.
The Importance of Secondary Prevention in Addressing Diabetes
In this episode, Samantha talks with Dr. Sam Robinson, Founder & President of Canary Telehealth, and Carla Robinson, CEO of Canary Telehealth, to discuss the work they’re doing in the diabetes space and how important it is in treating, managing and preventing diabetes complications.
IAMHP has made it to Fall and has taken some huge strides along the way!
This past month, the IAMHP podcast dedicated to Medicaid Managed Care was on hiatus as we geared up for in-person back to school - and planning to welcome another little one to the IAMHP family. Thanks for hanging in there with us! We are so excited to be back and kicking off the fall season of Sam Says.
To learn more about how IAMHP continues to push towards achieving better health outcomes for a healthier Illinois, check out our September Insights below.
As always, be well and stay safe!
Fall Quarterly Newsletter
The IAMHP team published the Fall Quarterly Newsletter this month. This edition focused on the notable steps IAMHP has taken in maternal health and the importance of preventative healthcare measures that may have been delayed due to the pandemic, such as cancer screenings and immunizations.
Culturally Competent Response to Community Needs
Alaina Kennedy, Chief Operating Officer of IAMHP and Laurinda Dodgen, Associate Vice President of Community Engagement at Molina Healthcare of Illinois came together to discuss strategies on building bridges between Molina and community-based organizations and partners such as Officer Patrice Turner, City of Rockford and Chris Javier, Deacon, Chinese Christian Union Church. To view the webinar, visit the link below.
Economic Case for Health Equity
IAMHP and 3M partnered for an important discussion on the implications of economics and social risks that lead to health inequities. The panelist explored the value of integrating clinical and social risks when considering development of value-based care strategies and how to understand the impact of social and clinical risk. To view the webinar, visit the link below.
Trusted Partner Program
Join the IAMHP Trusted Partner Program. IAMHP has been serving the needs of Illinois Medicaid members, health plans, industry partners and providers for many years. But improving healthcare delivery systems is a never-ending job. That is why trusted partnerships with industry leaders is so crucial in achieving our mutual healthcare goals. If you are interested in learning more about the program benefits visit our website via the link below.
This summer, IAMHP focused on preventative healthcare!
The healthcare ecosystem has a variety of initiatives taking place across Illinois aimed at improving healthcare access as well as addressing disparities and prevention.
To elevate some of these innovative programs, IAMHP hosted webinars, executive corners and podcasts.
Check out our links below to learn more about healthcare coverage, maternal health, cancer, oral health as well as well child visits and immunizations!
HealthCare Coverage and Preventative Care
IAMHP CEO, Samantha Olds Frey, and President of the Illinois Life and Health Insurance Council, Laura Minzer, discussed healthcare coverage and the importance of preventive care here in Illinois on the IAMHP SamSays podcast.
The IAMHP Team partnered with Representative Greenwood for an in-depth discussion on how Illinois legislators and Medicaid MCOs are driving innovation by implementing programs aimed at addressing disparities, reducing maternal mortality, reducing the risk of preterm birth & lessening disparities in preterm birth rates and supporting patient-centered care that improve the lives of families.
Cancer Screenings
IAMHP CEO, Samantha Olds Frey, discussed the importance of cancer screenings, how the pandemic affected preventative screenings and how crucial it is to reimplement them now.
Oral Health
Don Trainor, Government Programs Manager, and Dr. Henry Lotsof, Illinois State Dental Director at Avesis (a Guardian company and IAMHP Trusted Partner), sat down with IAMHP COO, Alaina Kennedy, to discuss the importance of oral health and its impact on overall health.
Well Child Visits and Immunizations
The EverThrive Team joined IAMHP for a discussion on the work the organization is doing in the immunization and well child visits space and the effect the pandemic has had on both.
During the COVID-19 pandemic, misinformation around vaccine safety has increased and with that, so has vaccine hesitancy. To support immunization efforts across the United States and here in Illinois, IAMHP partnered with the Illinois Chapter of American Academy of Pediatrics to discuss vaccine hesitancy and prepare providers for talks with parents and caregivers about vaccines.
In the first part of our three-part Care Coordination Series on SamSays, focused on the value of making connections, Kris Classen, Vice President of Healthcare Services for Molina Healthcare of Illinois discusses the critical role of care coordination in addressing social determinants of health.
In the second part of our three-part Care Coordination Series on SamSays, focused on the value of making connections, Vivian Moore, Director of Complex Care Coordination for CountyCare Health Plan, discusses the value of care coordination to address homelessness.
View Part 2
In the last part of our three-part Care Coordination Series on SamSays, focused on the value of making connections, Soccoro Romero, Registered Nurse Case Manager at Aetna Better Health of IL, discusses why care coordination is so important and why it isn't going away.
View Part 3
Series Wrap Up
In this episode, IAMHP CEO Samantha Olds Frey and COO Alaina Kennedy recap last month's Care Coordination Series on SamSays, focused on the value of making connections, including discussing some of their key takeaways from the series and guests.
View Wrap Up
Samantha Olds Frey, CEO of IAMHP, discusses what care coordination is and how its holistic approach can address issues like homelessness, bringing healthcare from hospital to home.
View Bonus Episode
Throughout the month of April, for Minority Health Month, IAMHP’s CEO Samantha Olds Frey joined Perri Small on WVON to talk about the Medicaid program and its importance as the healthcare safety-net for over 3 million Illinoisans.
In these weekly segments, Samantha and Perri discussed everything from the basics of the Medicaid program, black maternal health and how to address healthcare disparities, children’s mental health, and the COVID vaccine.
The first conversation specifically focused on the difference between Medicaid and Medicare, the benefit of managed care, and the eligibility for the Medicaid program and the healthcare coverage members receive from it.
Listen as IAMHP CEO, Samantha Olds Frey, breaks down everything Illinois’ extensive Medicaid program covers and why demand for it increased during the pandemic.
After covering the basics of Medicaid, Samantha and Perri discussed black maternal health and the efforts Medicaid health plans and the Department of Healthcare and Family Services are taking to address healthcare disparities. This discussion covered Illinois being the first state in the country to extend postpartum coverage to a full year and how this can help to address implicit bias, healthcare disparities and the high maternal morbidity rates in black mothers.
Listen as IAMHP CEO, Samantha Olds Frey talks about how legislation to extend postpartum coverage from 60 days to one full year is crucial for new mothers as they acclimate to what is normally one of the most challenging years they’ll face.
The Medicaid program is not only the largest payor of Mental Health services in Illinois, but it also covers approximately 1/3rd of children. In light of this, Perri and Samantha dove into a conversation about the many challenges children have had to face, from the pandemic and virtual learning to social unrest and reacclimating to in-person learning, and the toll it’s take on their mental health.
Listen as IAMHP CEO, Samantha Olds Frey describes how, though we’ve all faced challenges over the past year, the effect is especially detrimental to children, and why it’s so important to address their mental health now.
Finally, Samantha and Perri spoke about the importance of getting vaccinated and the support Medicaid health plans are offering to ensure vaccine access for all of their members.
Listen as IAMHP CEO, Samantha Olds Frey outlines how Medicaid health plans are ensuring Medicaid members get vaccinated and why Perri Small thinks it is “nothing short of remarkable.”
IAMHP was happy to join Perri Small and WVON to focus on healthcare policy and the Medicaid program for Minority Health Awareness month.
Learn about the latest news & insights on Illinois Medicaid for healthcare providers and healthcare advocacy groups by visiting our website IAMHP.net.
And like and follow us on Facebook, LinkedIn and Twitter.
February 2021
Childhood and adolescence are critical stages of life for mental health. This is a time when rapid growth and development take place in the brain. Children and adolescents acquire cognitive and social-emotional skills that shape their future mental health and are important for assuming adult roles in society.
This is why the Illinois Association of Medicaid Health Plans (IAMHP) partnered with the Medicaid Managed Care Organization Aetna Better Health of Illinois (ABHIL) to discuss their approach to holistic care management for children with behavioral health care needs through partnership with families and providers to ensure children have access to the care they need, when they need it.
“Member’s needs were not being met under the traditional model. I want to applaud Aetna Better Health of Illinois for thinking outside the box and for partnering with providers, like us, to provide for member’s needs in a more holistic fashion”
To view the presentation on Children’s Behavioral Health: Connected through Care, visit the IAMHP Video Library or check out our question & answers to catch the highlights from the webinar.
Q: Quickly summarize Aetna Better Health of Illinois’ approach to care management for children’s behavioral health.
A: Given the needs of children it is important to be flexible and adaptable. This includes having families, community organizations and Health Plans at the table working through the continuum of care to ensure care is delivered at the right time by the right people. That is why ABHIL created a dedicated children’s care management team specialized in the integration of care that ultimately wraps care around the children, the families, and the community so they have the supports they need to flourish. ABHIL also wanted to align ourselves with crisis providers to ensure a seamless experience for the members, which is why we partnered with providers such as, Family Service Association of Elgin.
Q: What changes and improvements have you seen since increased partnership between FSA and ABHIL? What lessons can you share from this partnership that attendees could benefit from?
A: We have seen increased communication and shared clinical information that is important for continuity of care. Things to take away would be that partnership among the provider, health plan, and member allow for a holistic treatment plan to be put into place.
Q: What changes have you seen in mobile crisis response in the past year given COVID?
A: We have seen the MCR providers make effective and timely transitions to providing telehealth services. This has increased satisfaction from both the providers and the members.
Q: What questions do you think the health care community needs to be asking itself in order to improve quality and care within Illinois?
A: How do we keep the ancillary members of a child or member’s life at the table and contributing to the member’s holistic well being? For children specifically, how do we ensure continuity of support at school and in the community? How can we prevent fragmentation of services to support the person, the family and the community?
Q: As attendees ruminate on this presentation what would you say is the most crucial item for them to contemplate or consider?
A: The most crucial item to consider is the support for a child. Support will mean something different to every individual, but that’s what makes it so crucial. Is something as simple as a journal enough to help the child feel more at peace, is ensuring that the child’s coach attends IEP meetings what makes their interests feel validated, or is it that the mother needs a ride to the grocery store so the family can eat? Children don’t exist in a vacuum, especially in a behavioral health crisis, so we wrap them in support (providers, people, places and things/resources) that are beneficial and member centered.
As the COVID-19 vaccination rollout continues, IAMHP wants to ensure Medicaid members stay up-to-date with the most current information and access to resources. Lack of access is still an issue for many so IAMHP, along with its member plans, are committed to partnering with community organizations to provide increased access to care and resources throughout the COVID-19 vaccination process.
What you need to know
There are two COVID-19 vaccines currently authorized and recommended for use in the United States, and three other vaccines are currently in large-scale clinical trials. Visit the CDC website to learn more about the different vaccines for COVID-19 and how vaccines work.
The process for who gets vaccinated and when is based on a phased strategy as vaccine supply is available using guidance from local, state and national public health authorities.
Vaccination phases include:
Phase 1A: Healthcare personnel and long term care facility residents Phase 1B: Individuals age 65 and older and front-line essential workers. Phase 1C: Individuals aged 16-64 with high risk conditions and essential workers not recommended in Phase 1B. Phase 2: All people aged 16 years and older not in Phase 1.
Phase 1A: Healthcare personnel and long term care facility residents
Phase 1B: Individuals age 65 and older and front-line essential workers.
Phase 1C: Individuals aged 16-64 with high risk conditions and essential workers not recommended in Phase 1B.
Phase 2: All people aged 16 years and older not in Phase 1.
How to sign up:
If you are an eligible individual as outlined in Phase 1A or 1B, such as health care workers, first responders, essential workers, or anyone 65 years of age and older, or if you are outside of Cook County or the City of Chicago and are 16 years of age and older with a high risk medical condition, find your nearest vaccination site.
For those living or working in Cook County, more information can be found at vaccine.cookcountyil.gov.
January 2021
Molina Healthcare Responds to Community Needs Amid a Pandemic
With the COVID-19 pandemic and heightened social unrest in 2020, health care has increasingly become a vital part of our communities’ lives. Molina Healthcare of Illinois and other providers play a pivotal role in meeting the needs of members, providers, and communities.
Recognizing The Need
The pandemic has exacerbated the impact of social determinants of health. Black and Latinx populations, people living in under-resourced communities, and lower-income individuals have been disproportionately impacted. Mandatory school closures have adversely affected nutrition and educational outcomes, and food insecurity has tripled among households with children. Massive layoffs have caused financial instability and limited access to quality health care services. Further, COVID-19 mitigation strategies have compounded mental health issues, grief, and bereavement in vulnerable populations at the intersections of age, income, employment, race, and ethnicity.
The Response
Molina recently established The MolinaCares Accord, an initiative created to improve the health and well-being of disadvantaged populations. The vision of MolinaCares is to change life and health for the better by identifying and reducing racial, social, and financial barriers to the access and delivery of quality health care.
Molina has also established employee resource groups (ERGs) throughout the enterprise. Molina CEO Joseph Zubretsky signed on to the CEO Action for Diversity and Inclusion, the largest CEO-driven commitment to advance diversity and inclusion in the workplace. Additionally, Molina is fostering an equitable work environment with a Diversity and Inclusion strategist to further implement inclusion strategies, programs, and initiatives.
Helping Communities
Even before the pandemic, Molina had been addressing social determinants of health including the health care system, educational access, economic stability, and food insecurity. In 2020, Molina Healthcare of Illinois partnered with community organizations to host a variety of events that followed social distancing guidelines. These included drive-through baby showers, flu clinics, winter coat drives, food drives, laundry service programs, and job fairs. Molina in Illinois hosted over 80 events across the state, distributed more than 40,000 pounds of food, 6000 hygiene kits, 3,000 COVID prep kits, and donated to over 52 community organizations.
Helping Providers
Molina has supported our providers during this time by expanding health programs—including telemedicine—distributing personal protective equipment (PPE) and addressing the unique needs in rural areas. Behavioral health provider fee schedules were increased by 20 percent from March 9 -June 30, resulting in over $1 million in additional funds to affected behavioral providers, and much more.
Moving Forward
Molina strives to remove barriers to care and address social determinants of health. Molina will continue to partner with providers and organizations to offer needed resources that help further support and serve communities most in need.
To learn more about how Molina is working to address the fundamental impact of the COVID-19 pandemic and heightened social unrest on vulnerable communities visit IAMHP’s Video Library.
For the latest news & insights on Illinois Medicaid visit www.IAMHP.net.
References
1. “Social Determinants of Health-Related Needs During COVID-19 Among Low-Income Households With Children” https://www.cdc.gov/pcd/issues/2020/20_0322.htm2. “COVID-19 and African Americans” https://jamanetwork.com/journals/jama/article-abstract/27647893. “Filling the school meal gap” https://www.chicagobusiness.com/crains-forum-education/filling-school-meal-gap4. “Food Insecurity Remains Elevated Across All 50 States” https://www.ipr.northwestern.edu/news/2020/schanzenbach-household-pulse-survey-analysis-report-2.html5. “Unintended Consequences of COVID-19 Mitigation Strategies” https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/disparities-impact.html
January Lunch & Learn Blog
The new year is such an important time for us to invest in ourselves, and that includes taking time to invest in our work skills and knowledge. We here at the Illinois Association of Medicaid Health Plans (IAMHP) want to help you start your year strong so we can all achieve better health care outcomes for Illinois residents this year.
That is why we brought you our latest Lunch & Learn training!
IAMHP hopes our January 2021 Lunch & Learn on the Illinois Medicaid Program Advanced Cloud Technology (IMPACT), our Comprehensive Billing Guide, and IAMHP Resources give you some new information that can help you this year.
This webinar was designed to provide guidance to contracted Medicaid providers who are responsible for billing services but is open to anyone who wants to learn more about the Medicaid program in Illinois or who want to learn more about MCOs and IAMHP.
To view our January Lunch & Learn visit the IAMHP video library or check out our question & answers to catch the highlights from the webinar!
Question: Approximately how long does it take the Department of Healthcare and Family Services (HFS) to review IMPACT information once it has been submitted?
Answer: As of January 20, 2021, if it is not a COVID-19 related application it takes approximately 30 to 45 days.
Q: Does HFS notify an MCO once a provider has been enrolled in IMPACT?
A: MCO can become aware or notified that a provider been approved and enrolled in IMPACT on a weekly extract file that is sent directly to an MCO. Weekly extract files are typically sent to health plans on Wednesday afternoon. Please note, there are a couple of technical processes that happen on the HFS side that can potentially create a little lag time between when a provider may get approved on IMPACT and when that information flows over to the health plans. Generally, HFS hopes to minimize that lag to a weeks’ time.
Q: Once a provider has been enrolled in IMPACT does the provider receive a notification?
A: Yes, once a provider is approved, they will receive a notification. Generally, a provider will receive a series of systematically generated emails once they start the application process. First, a provider will a generated email after they apply which will have basic information such as their application ID. Second, a provider will receive an email informing them that their application was approved. Third, a provider will receive an email 14 to 30 days after the IMPACT application has been approved with a generated provider information sheet.
Q: How should a health care facility remove a provider that is no longer associated with the health care facility?
A: The preferred and recommended course of action is to send an email to impact.help@illinois.gov requesting for that provider to be end dated. This ensures HFS is updating records accordingly. It should be noted, that a provider can also do this through the modification process.
Q: Can providers check in IMPACT to ensure they are enrolled before prescribing medication to a Medicaid member?
A: HFS implemented a provider directory on the HFS website specifically for the ordering referring and prescribing providers.
The information contained in this directory is made available to the public by HFS to assist Medical providers in verifying an actively enrolled ordering/referring/prescribing Medicaid provider. This directory is provided for informational purposes solely regarding a provider's enrollment and is not intended to guarantee payment for any service by any provider.
Q: Where there any complications with IMPACT during the third quarter of 2020? What measures are being taken to minimize complications moving forward?
A: The beginning of September of last year (2020), HFS was notified of some issues with their licenser interface. As a result of, providers who became inactive due to expiration of licenser were no longer enrolled in IMPACT. Once aware of the issue, HFS worked with their vendor to ensure that those interfaces are working.
There was a bit of an alarm again in the end of November and beginning of December when thousands of providers again became inactive due to licensure. It should be noted that many providers who licensure became inactive is because some providers licenses were extended due to the COVID pandemic.
HFS worked with IDFPR to try to get an extension for those licenses but the extension was not granted. IDFPR has to manually review every license application again and make that license active, due to short staffing this process can take time. HFS believes the last round of applications have been corrected.
HFS has tested the licensure interface and believes this process is now working. Nevertheless, these are interfaces we collectively rely on. When glitches to arise and HFS is made aware of these, HFS commits to working collaboratively with the vendor to ensuring those get resolved.
Collaboration with partners like IDFPR and feedback from providers and the MCOs are crucial when complications arise, or system/interface breakdowns potentially occur. HFS encourages providers and provider associations reach out to HFS so they can be made aware when those system issues might arise.
HFS has taken steps to ensure they stay on top of the feedback and stay on top of their processes. There are internal workgroups at HFS and workgroups between HFS and the MCOs specifically dedicated on provider enrollment. The workgroups plan on continuing to meet regularly.
There are also monthly HFS / IAMHP / MCO and Provider Association Meetings to discuss billing conversations and technical issues that arise.
The collective encourages you to utilize the tools available to you!
If you are interested in becoming a Trusted Partner, I encourage you reach out to Alaina Kennedy at alaina@iamhpteam.net or visit our website at IAMHP.net.
As part of being a Trusted Partner you actually have the opportunity to attend all of our Lunch & Learns for complimentary, among many more benefits.
