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Health & Medicine's Comments Delivered to HFS Director Hamos on the Dual Eligible Initiative Proposal from HFS

Health & Medicine Policy Research Group (HMPRG)
March 21, 2012

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Dear Director Hamos,

Thank you for the opportunity to submit comments on the Illinois Medicare-Medicaid Alignment Initiative Proposal (Initiative, or Proposal).  Health & Medicine Policy Research Group (HMPRG) is pleased to see Illinois, and in particular the Department of Healthcare and Family Services (Department), developing specific and strategic programs to serve the vulnerable and complex individuals who are dual Medicare and Medicaid eligible (dual eligibles). 

HMPRG has for over 30 years supported a public health system that is centered on a care coordination model that is person-centered, that integrates funding streams, that helps individuals remain healthy and out of institutional care settings, that improves the quality of care provided, and that lowers the cost of care. HMPRG agrees with the Department’s statement of the problem as presented in the Executive Summary of the Proposal: our current system of care (including acute, primary, long-term, emergency) is fragmented for Medicaid beneficiaries, and even more so for dual eligibles.  Indeed, for the reasons the Department outlines in the Executive Summary, it is precisely this fragmentation and lack of care coordination that leads individuals in poor health to have frequent visits to myriad healthcare settings, and ultimately results in high care costs with less than optimal health outcomes.

In this testimony, HMRPG will comment on the following issues as referenced in the Department’s Proposal:

  1. The timeline proposed for implementation of the Initiative
  2. The necessity to coordinate Medicare/Medicaid covered services and non-covered medical and social services
  3. Coordinating with HCBS case managers
  4. Care management risk stratification
  5. Care coordinators
  6. Multi-disciplinary team responsibilities
  7. Care plan development
  8. Care transitions

Download the full comments and recommendations