Your Source for Health Reform

Topic: Medicaid Care Coordination

Illinois law requires 50% of Medicaid beneficiaries to be enrolled in coordinated care by 2015. Coordinated care plans include a choice of primary care physician, a care coordinator, and a provider network. They are available through managed care organizations or health provider groups. The plans vary by how they are reimbursed and designed, and some may offer some extra benefits, but all traditional Medicaid benefits are guaranteed.

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Managed Long Term Services and Supports

Starting July, 2016 managed care organizations will be responsible for coordinating long-term services and supports for people who live in a nursing facility or receive home and community-based services through a Medicaid waiver program. This April 2016 fact sheet from Health & Disability Advocates informs consumers about the change.

ACEs, Bs and CCEs

This December 2014 FAQ from the Illinois Department of Human Services details general enrollment and access to care procedures for consumers and providers in Medicaid managed care.

Do New Health Delivery Models Really Deliver?

This December 2015 report from Community Catalyst provides policy and operational recommendations that promote person-centered and coordinated care in dual-demonstration programs.

Targeting the Social Determinants of Health

This December 2015 brief from the Center for Health Care Strategies explores approaches to using Medicaid funding for non-medical services. The approaches are  utilized as part of state-based coordinated care initiatives.

Trusted Voices Transform Care

This November 2015 issue brief from Community Catalyst outlines how Community Health Workers can play a role in health system reform. The brief identifies funding sources to finance these positions and pathways for involving Community Health Workers in local partnerships.

Care for the High-Need High-Cost 

This November 2015 multimedia article from the Commonwealth Fund describes innovative health care delivery and payment models being used for patients with chronic conditions.

Mobile and in MMAI

This June 2015 FAQ from EverThrive reviews enrollment policies concerning Medicaid managed care beneficiaries who move to a different county.

Help! I Lost My Medicaid

This October 2015 FAQ from The Chicago Coalition for the Homeless, Shriver Center, EverThrive Illinois and the Legal Assistance Foundation of Chicago answers common questions about Medicaid redeterminations in Illinois.

Effective Health Care Outreach

This September 2015 brief from the Center for Health Care Strategies presents approaches for engaging with Medicaid and Medicare eligible health care consumers. This group is more likely to have chronic health conditions and is harder to engage.

What Happens After Enrolling in Medicaid Coordinated Care?

This May 2015 timeline from Health & Disability Advocates and the Make Medicare Work Coalition outlines what  enrollees should expect from their managed care plans.

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