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Illinois Integrated Care Program Information 

 

Integrated Care Program (ICP)

The Illinois Department of Healthcare and Family Services (HFS) implemented the state’s first integrated health care program on May 1, 2011. The Integrated Care Program (ICP) is a program for older adults and adults with disabilities who are eligible for Medicaid but not eligible for Medicare.  The program is mandatory and operates in the pilot areas of suburban Cook (all zip codes that do not begin with 606), DuPage, Kane, Kankakee, Lake and Will Counties. The Integrated Care Program brings together local primary care providers (PCPs), specialists, hospitals, nursing homes, and other providers to organize care around a patient’s needs. It keeps enrollees healthy through more coordinated medical care, helping to prevent unnecessary healthcare costs. 

As of February 1, 2013, there were 36,079 individuals enrolled in ICP. All individuals enrolled in ICP are currently receiving services under Service Packages 1 and, if eligible, Service Package 2 (see description below). 

Integrated Care Program Administrator

The Illinois Department of Healthcare and Family Services contracted with Aetna Better Health and IlliniCare Health Plan to administer the program.

Aetna Better Health, Inc. has over 25 years experience in Medicaid managed care programs in nine states, serving 1.2 million enrollees. This includes comprehensive care management to more than 277,000 older adults and adults with disabilities in eight of those states. 

Centene Corporation, which operates in Illinois under the name IlliniCare Health Plan, has over 25 years experience in Medicaid managed care programs in 18 states, serving 2.5 million enrollees, including older adults and persons with disabilities. 

Illinois Client Enrollment Broker

HFS contracts with MAXIMUS, Inc. to operate Illinois’ Client Enrollment Services. Illinois’ Client Enrollment Services will:

Enrolling Clients

Client enrollments are handled by Illinois’ Client Enrollment Services. There are two ways clients can enroll:

An initial client enrollment packet is mailed to households with potential enrollees. The packet includes:

A second client enrollment packet is mailed to clients who have not responded to the initial client enrollment packet within 30 days.  The packet includes a cover letter with the name of the health plan and PCP to whom the client will be assigned if they don’t make a choice within the next 30 days.

Service Packages

Service Package I – Implemented May 1, 2011.  All standard Medicaid medical services, such as physician and specialist care, emergency care, laboratory and X-rays, pharmacy, mental health and substance abuse services

Service Package II – Implemented February 1, 2013. This package includes Nursing Facility services and the care provided through some of the Home and Community-Based Service (HCBS) waivers operating in Illinois (excluding Developmentally Disabled/DD waiver services).

Nursing Facility Services are long term care services covered by the Department for Medicaid-eligible residents and include Skilled Nursing Facilities and Intermediate Care Facilities (SNF and ICF).

Home and Community-Based Service (HCBS) waivers allow participants to receive non-traditional services in the community or in their own homes, rather than being placed in an institutional setting. Illinois currently operates nine HCBS waivers, five of which will be included during Service Package 2.  The remaining three Developmentally Disabled (DD) waiver services will be included during Service Package III. The MFTD waiver services will be discussed at a later date.

Service Package III – DD Waiver services; will begin approximately one year after Service Package II implementation

Eligible and Excluded Populations

Eligible Populations (Aged, Blind, Disabled) = approximately 36,000

Excluded Populations:

MORE INFORMATION  

To get more information about Illinois’ Integrated Care Program, please contact: