An Independent Evaluation of the Integrated Care Program. Final Report: Findings through the Third Year (FY14)

August 2015
Tamar Heller, Randall Owen, Dale Mitchell, Yochai Eisenberg, Coady Wing, Anne Bowers, Caitlin Crabb, Kiyoshi Yamaki, Chris Keys, Lindsey Back, Hailee Gibbons, Mandy Schmidt, and Judah Viola

Over the past several years, the State of Illinois has been implementing and planning several programs to move Medicaid and Medicare recipients into systems of care coordination. The original, mandatory Medicaid managed care program (MMC) in Illinois is known as the Integrated Care Program (ICP) and began on May 1, 2011 with the goal of improving the quality of care and services that the Medicaid population receives, along with saving the State money on Medicaid expenditures (estimated at $200 million over the first 5 years). The program serves seniors and people with disabilities who are Medicaid-only eligible who originally resided in the suburbs of Cook County (not including the City of Chicago) or the five collar counties (DuPage, Kane, Kankakee, Lake, and Will counties). The program later expanded into other areas of the state but this study focuses only on the original area of collar counties in the Chicago area.

For the first two years, the ICP only covered acute healthcare services (Service Package 1), but beginning in February 2013 the Managed Care Organizations (MCOs) also became responsible for long-term services and supports (LTSS) (Service Package 2) for all of their members except for people on the developmental disability waiver.

The State of Illinois (through the Illinois Department of Public Health) contracted with the University of Illinois at Chicago (UIC) to conduct an independent evaluation of the ICP. This report presents results through the third full year (FY14) after ICP was implemented.

The results in this report are based on both qualitative and quantitative data, including focus groups conducted with stakeholders; yearly consumer satisfaction surveys; and analysis of Medicaid encounter data, MCO data, and reports the MCOs submit to the Department of Healthcare and Family Services (HFS). Many of the analyses include a comparison group of people in Fee-for Service (FFS) who would be eligible of ICP but lived in Chicago and were not eligible for ICP at the time period included in the analyses. The comparative analyses control for demographic and health differences between the groups. Consultation with an active advisory board and participation in various stakeholder, MCO, and HFS meetings provided direction to this evaluation.

This report is the final report of the four year evaluation of ICP. This final report is organized around key questions and the major findings for these questions are summarized below. Also included is a section on “lessons learned” and recommendations for the future of ICP and other Medicaid managed care initiatives for individuals with disabilities and older adults in Illinois.

Last modified Mar 18, 2016