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1115 Medicaid Waiver

Illinois’ Behavioral Health Transformation – 1115 Overview

In the State of the State, Illinois announced a Health and Human Services Transformation that places a focus on prevention and public health; pays for value and outcomes rather than volume and services; makes evidence-based and data-driven decisions; and moves individuals from institutions to community care to keep them more closely connected with their families and communities.

Since then, the Illinois Department of Healthcare and Family Services (DHFS) has been collaborating with the Governor’s office and 11 other state agencies, including representatives from health, human services, education, and criminal justice as well as a broad stakeholder community to bring these focus areas to fruition.

The initial focus of the transformation effort has been on behavioral health (mental health and substance use) and specifically the integration of behavioral and physical health service delivery. Behavioral health was chosen due to both the urgency of the issue and the potential financial and human impact. Medicaid members with behavioral health needs or “behavioral health members” represent 25% of Illinois Medicaid members but account for 56% of all Medicaid spending. Further, building a nation-leading behavioral health strategy will help turn the tide of the opioid epidemic, reduce violent crime and violent encounters with police, and improve maternal and child health.

​ Access 1115 Waiver Documents and Provide Comments

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