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Illinois' Medicaid MC expansion is unique
It is the broad inclusion of all services that makes Illinois' managed care expansion unique, according to James Parker, deputy administrator for medical programs at the Illinois Department of Healthcare and Family Services.
"That is what I think other states will be going to," says Mr. Parker. "Instead of carving out behavioral health, or long-term community supports, we are putting all those services that people need in one contract."
To date, Illinois Medicaid hasn't had to cut any optional services, says Theresa Eagleson, administrator of the division of medical programs for Illinois' Medicaid agency. "Hopefully, this will avoid us spending the money on the more traditional institutional services down the road," she says. "Hopefully, we can avoid those cuts. State budget situations aren't looking great, but that is our hope."
Ms. Eagleson says that the managed care expansion is in no way an attempt to reduce services, but rather, to enable clients to access the care they need. "We often hear, especially with more complex mental health or substance abuse issues, that clients need to deal with not only a myriad of providers, but also different funding streams from the state," she says.
The managed care expansion will simplify things for both providers and clients, says Ms. Eagleson.
According to Mr. Parker, as many as 40% of Illinois Medicaid's high-cost, high-needs clients have a behavioral health diagnosis. For this reason, he says, it's very important to integrate behavioral and physical health care.
"There is a lot of evidence that people with behavioral health problems have much worse physical health care," says Mr. Parker. "This is because they are often only intersecting in the behavioral health system. If you can tie the two together, it is much more likely their needs will be met."
Contact Mr. Parker at (217) 782-2570 or James.Parker@illinois.gov.