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Balancing Incentive Program

​The Balancing Incentive Program (BIP) authorizes enhanced Federal Medicaid matching funds to States to increase access to non-institutional long-term services and supports (LTSS) as of October 1, 2011. Illinois’ BIP application was approved June 12, 2013.

Per the Federal Centers for Medicare and Medicaid Services the Balancing Incentive Program will help States transform their long-term care systems in the following ways:

  1. Lowering costs through improved systems performance & efficiency

  2. Creating tools to help consumers with care planning & assessment

  3. Improving quality measurement & oversight 

The Balancing Incentive Program also provides new ways to serve more people in home and community-based settings and is closely tied with current Long Term Care Rebalancing initiatives in Illinois such as the MFP program. The BIP supports the integration mandate of the Americans with Disabilities Act (ADA), as required by the Olmstead decision, and was created by the Affordable Care Act of 2010 (Section 10202).

The Balancing Incentive Program increases the Federal Matching Assistance Percentage (FMAP) to States that make structural reforms to increase nursing home diversions and access to non-institutional LTSS.  The three structural reforms are:

  1. A no wrong door/single entry point system (NWD/SEP),

  2. Conflict-free case management services

  3. Core standardized assessment instruments.

The enhanced matching payments are tied to the percentage of a State’s LTSS spending. Illinois will receive a 2% increase in FMAP through the BIP funding period.  States must agree to use the enhanced FMAP only to provide new or expanded home and community-based LTSS.

Illinois BIP Application and Award Announcement

  1. Application (pdf)

  2. Award (pdf)



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Illinois Department of Healthcare and Family Services

JB Pritzker, Governor • Theresa Eagleson, Director