Illinois Medicare-Medicaid Alignment Initiative
A broad array of quality-driven providers are needed to implement and support the State of Illinois new Medicare and Medicaid initiative.
The State of Illinois is contracting with health plans to enter into risk-based contracts for the Medicare-Medicaid Alignment Initiative. MMAI is focused on integrating health care delivery and payment for those who are eligible for both Medicare and Medicaid (dual eligibles). Contracted health plans will provide the full spectrum of Medicare and Medicaid Covered Services through an integrated care delivery system to a significant portion of seniors and adults (aged 21 and over) with disabilities that are eligible for Medicare (Parts A and B) and Medicaid (full-benefit Medicaid eligibles).
The primary goals of the Initiative include:
- Create a unified delivery system that is easier for beneficiaries to navigate.
- Improve care delivery, coordination, and utilization of community-based services.
- Eliminate conflicting incentives between Medicare and Medicaid that encourages cost shifting.
- Increase beneficiary access to high-quality care and community-based services.
- Increase Care Management for chronic conditions.
Geographic Areas Served & Number of Potential Enrollees
Humana will operate the Medicare-Medicaid Alignment Initiative in the Greater Chicago Area. Independent Living Systems (ILS) has been engaged to assist Humana with a focus on Long Term Services and Supports (LTSS).
- Greater Chicago Area: Cook, DuPage, Kane, Kankakee, Lake, and Will counties.
Full array of benefits and supportive service afforded individuals under Medicare, Medicaid, and LTSS (long-term services and support) including but not limited to:
- Inpatient and outpatient services.
- Durable medical equipment.
- Skilled nursing facilities and home health.
- Behavioral Health.
- Long-term institutional and community-based supports and services.
LTSS Provider Partners
Health Plans must support a robust network of both Medicare and Medicaid providers sufficient to meet the needs of dual eligibles. Program success will rely on a network of primary care providers (PCPs), clinics, hospitals, nursing facilities, pharmacies, specialty care providers, dentists, oral surgeons, mental health professionals, and providers of Long Term Services and Supports. Social workers, health educators, home health nurses, aides, self-directed personal assistants, speech, occupational and physical therapists, nutritionists, and other providers are also necessary to improve the health and well-being of Medicare-Medicaid enrollees in this new program.
Long Term Services and Support (LTSS)
|Adult Day Service||Adult Day Service Transportation|
|Case Management||Community Transition Services|
|Environmental Accessibility Adaptations (Home)||Supported Employment|
|Prevocational Services||Habilitation Day|
|Homemaker||Home Delivered Meals|
|Personal Assistant||Personal Emergency Response System (PERS)|
|Respite||Specialized Medical Equipment and Supplies|
|Supportive Living Facilities||Behavioral Services (M.A. and PH.D)|
|Home Health Aide||Skilled Nursing|
|Intermittent Nursing||Occupational Therapy|
|Physical Therapy||Speech Therapy|
Contact us at firstname.lastname@example.org to obtain more information including the Provider Agreement and Credentialing Application.
You may also contact us at 855-661-2029 should you have additional questions. We look forward to seeing you at one of our upcoming events that will held for the LTSS network Providers.