Blue Cross and Blue Shield of Illinois Chosen to Administer Health Coverage for Dual-Eligible Residents in Chicago Area
Chicago, IL — Blue Cross and Blue Shield of Illinois (BCBSIL) announced today that the Illinois Department of Healthcare and Family Services has chosen it to participate in the state's demonstration project aimed at integrating health care for people who qualify for both Medicare and Medicaid — individuals often referred to as "dual eligibles" — as part of the Illinois Medicare-Medicaid Alignment Initiative (MMAI).
BCBSIL, the state's largest health insurance provider with over 7.2 million members, has served the needs of Illinois residents since 1936. "We're honored to be chosen to partner with the state to better coordinate care and meet the special needs of seniors, the disabled and our more vulnerable citizens," said Karen Atwood, president of BCSBIL. "First and foremost, we're entrusted to serve them through a person-centered approach to care delivery. By doing so, we aim to improve their quality of life while serving as stewards to responsibly manage the associated healthcare costs." Under the new project, BCBSIL will serve Illinois residents in the Greater Chicago area, consisting of Cook, Lake, Kane, DuPage, Will, and Kankakee counties. Approximately 118,000 dual-eligible residents reside in these counties. The State selected the region because of the high density of dual-eligibles and the availability of a robust medical care infrastructure.
Under the ILMMAI program, BCBSIL will be responsible for coordinating enrollees care, and to provide the following:
- Medical services
- Behavioral health services
- Pharmacy services
- Long-term services and supports (LTSS)
The ILMMAI program, upon receiving federal approval, will be part of the Centers for Medicare & Medicaid Services' (CMS) Medicare-Medicaid Plans (previously referred to as Financial Alignment Demonstration Plans), which focus on integrating Medicare and Medicaid benefits and services to create a unified, easy-to-navigate health care system for the dual-eligible population.
The ILMMAI program is one in a series of Illinois initiatives intended to move the health care environment to one that is more person-centered, focused on improved health outcomes, enhanced patient safety, and offers greater access to care. BCBSIL is strongly positioned to provide improved care delivery for dual-eligible beneficiaries through its extensive network of providers, and innovative health care management programs and partnerships. "We identify and address gaps in care, and work to close them by taking a proactive lead in care coordination for individuals with chronic or complex health conditions," says Opella Ernest, MD, BCBSIL's chief medical officer. She adds, "BCBSIL concentrates its condition management efforts where it will have the greatest impact — through a comprehensive, integrated model of care that identifies the range of needs and opportunities to enhance each individual's quality of life and independent functioning by actively engaging their involvement, their caregivers, and a full range of medical, behavioral health, and social service providers." Dr. Ernest added, "Above all, we know Illinois, its residents, and we understand Illinois' health care challenges."
Blue Cross and Blue Shield of Illinois
With more than 7.2 million members, BCBSIL, a division of Health Care Service Corporation, a Mutual Legal Reserve Company, is the largest health insurance company in Illinois. Begun in Chicago in 1936, BCBSIL is committed to promoting the health and wellness of its members and its communities through accessible, cost-effective, quality health care.