, a Cigna company, has been awarded a three-year contract with the Illinois Department of Healthcare and Family Services to provide managed care services to dual-eligible beneficiaries in Greater Chicago as part of the Illinois Medicare-Medicaid Alignment Initiative (ILMMAI). The ILMMAI program, upon receiving federal approval, will be part of the Centers for Medicare & Medicaid Services’ (CMS) Medicare-Medicaid Plans (previously referred to as Financial Alignment Demonstration Plans), which center on integrating Medicare and Medicaid benefits and services to create a unified, easy-to-navigate health care system for the dual-eligible population.
The ILMMAI program is one in a series of the State’s initiatives to transform the health care environment in Illinois to one that is more patient-centered, with a focus on improved health outcomes, enhanced patient safety and better access to care. Illinois health care data indicate a clear need to improve care delivery for dual-eligible beneficiaries and to shift long-term care utilization from institutions to community-based services. A 2011 CMS report showed that Illinois is the nation’s sixth highest in potentially avoidable hospital readmission rates among dual-eligible beneficiaries.
“We are pleased to join together with the Illinois Department of Healthcare and Family Services to offer a full array of health care benefits and services to Illinois residents,” said Herb Fritch, president of HealthSpring. “HealthSpring’s coordinated care model has yielded proven results for dual-eligible patients and our focus on personalized and preventive care aligns well with the State’s vision to deliver better access to care and improved patient outcomes for the dual-eligible population.”
Under the ILMMAI program, HealthSpring will be responsible for coordinating enrollees care and for providing the following:
- Medical services
- Behavioral health services
- Pharmacy services
- Long-term services and supports (LTSS)
Enrollment in the demonstration is voluntary and the approximately 118,000 eligible beneficiaries in the Greater Chicago area may select which plan to join or opt out to stay with traditional Medicaid. The Greater Chicago service area for the ILMMAI demonstration includes six counties: Cook, Lake, Kane, DuPage, Will and Kankakee. The State selected this region because of the high density of dual-eligible beneficiaries and the existence of a robust medical infrastructure.