Welcome to HealthChoice Illinois: The new, smarter Medicaid managed care
Beginning January 1st, 2018, Illinois is transitioning their managed care program into a more streamlined, accountable, and integrated program. The new, member-centric HealthChoice Illinois Program will provide enhanced quality and improved outcomes, all while managing cost. Statewide, providers now have an opportunity to contract with each of the 5 (7 in Cook County) qualified, experienced, and financially sound managed care plans that have been chosen to provide services.
What is improving in 2018?
Providers will see many positive changes:
· Managed care will be expanded to provide services for clients statewide, reaching approximately 80% of Medicaid enrollees
· Special needs children, including children receiving SSI and children in the Medically Fragile Technology Dependent waiver, will be included in the managed care population with an anticipated effective date of October 1, 2018. So will DCFS youth.
· Effective July 2018, there will be a single preferred drug list, with the potential for additional drugs depending on the plan, meaning better continuity of care and less time looking up information.
· New uniform credentialing process makes it easier for providers to enroll. There will no longer be a need to credential separately through each plan individually. Providers will only need to credential once through IMPACT.
For more on these and other benefits, see the “Succeeding with the new Managed Care Program” notices. Strategies to help clients transition to HealthChoice Illinois are also included.
What are the goals of HFS’s new HealthChoice Illinois program?
· Streamline current managed care programs and reduce confusion for enrollees and providers by offering the information needed to make smart health care choices
· Increase integration of behavioral and physical health
· Provide a health plan and primary care provider (PCP) for every client
· Offer Care Coordination to help clients with complex needs navigate the health care system
· Align State and MCO objectives to enhance quality and improve outcomes
How and why should a provider participate in HealthChoice Illinois?
Contracting with health plans now will allow providers to continue serving existing patients throughout the transition and beyond. To contract with a health plan, providers should contact the plan directly to speak about qualifications or contractual agreements.
HFS built HealthChoice Illinois after listening to the concerns and suggestions of providers like you. Smarter and more efficient than ever, we think you’ll discover the new program significantly reduces administrative requirements -- so you can focus on client care.