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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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Medicaid Care Coordination Roll-out by Health Plan

This March 2014 diagram from HFS details the MCOs and provider groups that will be coordinating care for Illinois Medicaid, the eligibility category they will serve, when each program will start, and what geographic regions they will serve.

Care Coordination Roll-out Map

By January 1, 2015, 50% of Medicaid members must be enrolled in managed care. This HFS map details the expansion of Medicaid Care Coordination projects across the state, including the Integrated Care Program, Care Coordination Entities, the Medicare Medicaid Alignment Initiative, and Voluntary Managed Care Organizations.

Medicaid Health Homes and Patient Centered Medical Homes

This fact sheet from SAMHSA compares and contrasts Medicaid Health Homes and Patient Centered Medical Homes. Health and Medical Homes are both coordinated care models intended to assist in managing complex care.

Medicaid Eligibility, Enrollment Simplification, and Coordination

This December 2012 brief from the Kaiser Family Foundation summarizes the major provisions of the CMS final rule, issued March 23, 2012.

Care Coordination, Managed Care and Long-Term Services and Supports 

This 2012 document from Health and Medicine Policy Research Group charts the roadmap for federal and state initiatives in these areas, both those already in effect and those to be phased in during 2013.

Medical Home Network Care Coordination Pilot

February 2012 announcement by the Medical Home Network that it has been designated by the Illinois Department of Healthcare and Family Services as a pilot healthcare project to test and evaluate care coordination initiatives expected to enhance quality and reduce the cost of care for approximately 170,000 Medicaid beneficiaries in Illinois.

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