Illinois’ Medicaid reform law calls for 50 percent of Medicaid recipients to be enrolled in a care coordination program by January 2015.

As care coordination is implemented in Illinois, IAMHP is committed to clear and respectful communications with patients and providers.

What is care coordination?

Care coordination involves the development of a patient-centric care plan for every member. Integrated care teams develop care plans and partner with providers to oversee delivery of medical and behavioral health services, as well as services for social needs, in an integrated and holistic manner. Care plans emphasize wellness and continuity of care, and utilize quality measures and patient outcomes to measure success.

How does Illinois benefit from care coordination?

The traditional Medicaid system is disjointed and rewards quantity over quality of services. The health of a Medicaid member should always be the number one concern, not the number of procedures performed. Care coordination assists Medicaid members in navigating the complex healthcare system, rather than having them fend for themselves. Care coordination requires that each managed care organization focuses on the totality of a member's health and social situation, not just what is traditionally seen as healthcare.

What consumer protections exist in Medicaid managed care?

The Illinois Association of Medicaid Health Plans and its member organizations are strongly committed to quality and consumer protections. IAMHP recognizes that in order for care coordination to work, the best interest of the Medicaid member must be our chief concern. This is why IAMHP is pursuing legislation that would require all Medicaid care coordination organizations to be accredited by a national accreditation agency, such as the National Committee for Quality Assurance. Further, IAMHP believes that regardless of the care coordination model in which a member is enrolled, all members should be covered by the same set of rights and protections.

What do long-term care providers need to know about care coordination?

Please see IAMHP’s presentation Managed Care Billing: What You Need to Know and list of LTC Questions and Answers for information about what the transition to care coordination means for LTC providers.

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