Medicaid Managed Care in Illinois: Where Have We Been, and Where Are We Going?
ISMS members: Free
Non-ISMS members: $75.00
Physicians who treat Medicaid patients have experienced significant hassles as a result of the transition to managed care – not to mention the burden on Medicaid patients themselves. The Illinois Department of Health and Family Services (HFS) began enrolling Medicaid recipients into Managed Care Organizations (MCOs) in 2014, but in light of these problems, the state is already planning to overhaul the Medicaid Managed Care program.
As of Jan. 1, 2018, a new set of managed care entities are expected to:
- Align state and MCO objectives to enhance quality;
- Increase integration of behavioral and physical health;
- Streamline current managed care programs;
- Achieve greater managed care coverage across Illinois; and
- Manage costs without compromising quality or access.
There is hope that the planned changes will address many of the program’s challenges. But the stakes are high, and physicians should be prepared for what’s ahead.
Get the scoop on what your responsibilities and obligations might be – and to make sure you and your practice are not caught off-guard in the coming months.
At the conclusion of this learning activity, participants will be able to:
- Learn the background and current status of the Medicaid Managed Care program in Illinois
- Recognize efforts underway to address the administrative barriers physicians face in treating Medicaid Managed Care patients
- Identify key elements of the new MCO contracting process and their potential impact on expectations related to delivery of care to Medicaid patients
All faculty, content reviewers and planners who have had input into or contributed to the content have indicated they have no relevant financial relationships with any commercial entities that may have an impact on the activity.
ISMS members and their staff
The Illinois State Medical Society is accredited by the ACCME to provide continuing medical education for physicians.
The Illinois State Medical Society designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Illinois Nurse Practice Act rules deem CME credit provided by approved sponsors as acceptable to fulfill nursing continuing education requirements for licensure. Nurses may claim one contact hour per unit of CME in the state of Illinois.
The recommendations contained in this resource are not intended to define conduct that is appropriate in every case, should not be considered as establishing any standard of care, and do not constitute legal advice. Physicians, clinicians and health care providers should take care to ensure that all care rendered reflects the best clinical judgment and complies with the laws and regulations of the state or location at which the care was provided.
Vice President, Member Advocacy
Illinois State Medical Society
- 1.00 AMA PRA Category 1 Credits™
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Illinois State Medical Society and ISMIE Mutual Insurance Company. The Illinois State Medical Society is accredited by the ACCME to provide continuing medical education for physicians.
The Illinois State Medical Society designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.00 Participation Credit
ISMS member cost: Free
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