Health News
SB 26 to be signed by the Governor into law on July 22, 2013, will expand Medicaid to over 600,000 new potential enrollees but it will also usher in a new form of coordinated care in Illinois for these new Medicaid enrollees as well as existing families on Medicaid - the Accountable Care Entity.
An Accountable Care Entity (ACE) will be a new Illinois model of an integrated delivery system. This will be the fourth model providing ?care coordination services? for Medicaid clients, which now includes Managed Care Organization (MCO), Managed Care Community Network (MCCN) and Care Coordination Entity (CCE). This infographic provides a great overview of the system so far.
The ACE will have these elements:
The initial population assigned to ACEs will be children and family members (and likely newly eligible Medicaid clients under the Affordable Care Act.)
For more information check out the HFS Care Coordination Site
Stephanie Altman
Health & Disability Advocates
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Health News
Accountable Care Entities (ACEs): A New Coordinated Care Model in Illinois
SB 26 to be signed by the Governor into law on July 22, 2013, will expand Medicaid to over 600,000 new potential enrollees but it will also usher in a new form of coordinated care in Illinois for these new Medicaid enrollees as well as existing families on Medicaid - the Accountable Care Entity.
An Accountable Care Entity (ACE) will be a new Illinois model of an integrated delivery system. This will be the fourth model providing ?care coordination services? for Medicaid clients, which now includes Managed Care Organization (MCO), Managed Care Community Network (MCCN) and Care Coordination Entity (CCE). This infographic provides a great overview of the system so far.
The ACE will have these elements:
- Will be a provider-organized network of care -- providers working together collaboratively
- Will be large enough to have impact for a population: initially children and their family members in Illinois Medicaid, at least 40,000 in Cook County, 20,000 in collar counties, 10,000 downstate
- Will have at a minimum the following types of providers: primary care, specialty care, hospitals, and behavioral healthcare; will have a governance structure that includes each type of provider and works to create a shared culture of collaboration/transformation
- Will build an infrastructure to support care management functions among the providers in the network, such as health information technology, risk assessment tools, transparent data and data analytics, communication with Medicaid members, etc.
- Will work toward a new payment structure different from the current fee-for-service: shared savings within first 18 months, partial risk after 18 months and full risk after 3 years, which means capitated payments with financial incentives for the providers within the network
The initial population assigned to ACEs will be children and family members (and likely newly eligible Medicaid clients under the Affordable Care Act.)
For more information check out the HFS Care Coordination Site
Stephanie Altman
Health & Disability Advocates
- Providers Will Make Medicaid Care Coordination A Success
If the opening of the health insurance marketplace taught people anything, it?s that choosing health insurance is tough. Suddenly, people had to make a thorough evaluation of their finances, the types of care they depended on, the medications they needed,...
- Provider-plan-payer Alliance For Health - Your Input Is Needed
Illinois was recently awarded a Model Design grant from the Center for Medicare & Medicaid Innovations (CMMI) for the development of a State Health Care Innovation Plan. Through these grants, CMMI is encouraging states to develop multi-payer approaches...
- Dual Eligibles Next To Move Into Managed Care In Illinois
On February 22, the U.S. Department of Health and Human Services announced a Memorandum of Understanding (MOU) with the state of Illinois for a demonstration project that will enroll approximately 136,000 dual eligibles in northeastern and central Illinois...
- Moving Forward: Current Waivers For Coordinated Care Projects In Illinois
?Care Coordination,? along with related terms like ?managed care? and ?medical home? have become the buzz words of health care reform. The terms refer to new types of health care delivery models that many states and programs are turning to as the key...
- The State Of Illinois And Medical Home Network Partner For Improved Care Coordination
Last week the Illinois Department of Healthcare and Family Services and the Medical Home Network (MHN) announced an innovative partnership that could mean better care and lower cost of care for Medicaid beneficiaries. MHN is one of the largest collaborations...