Illinois Health: Delay of the Integrated Health Home Implementation plan

An issue addresses the delay of the Integrated Health Home (IHH) program due to rulemaking provisions.

This issue was addressed by A.J. Wilhelmi, President and CEO of Health Policy, and Lia Daniels, manager of Health Policy.

What is the Illinois Integrated Health Home Implementation plan?

The Integrated Health Home program is a coordination program focused on the physical health, behavioural health, and social care of participants in the Illinois Medical Assistance Program. This plan will deliver improvements across a range of areas, including improvements in care delivery. Higher-needs population will have higher-intensity Integrated Health Homes.

This new form of care is for all members who are part of the Illinois Medicaid population. Based on the level of the Medicaid member’s need, they will be linked to an Integrated Health Home provider.

As stated on the bhecon website, “Medicaid individuals with diagnosed behavioral health needs make up ~25% of the population, but ~56% of the total spend”. These challenges are addressed by the objectives of the Illinois HHS transformation. As mentioned on the same website, enhanced identification, screening and access will be offered to provide high-quality services for behavioural and physical health. Enough support, through structure and budgeting, will also be offered to provide an effective streamlined state system.

Three Town Hall meetings on the topic were held in Springfield, Downers Grove, and Chicago from August 8-10. These meetings focused on providing details of the approved State Plan implementing the Integrated Health Home Implementation. Strong emphasis was placed on enhancing care coordination so that Medicaid beneficiaries would meet their physical, behavioural, and social care needs.

The Vision of the Integrated Health Home Plan

The IHH transformation has been enabled by various levels of collaborations in the Illinois health industry. There are 13 agencies, departments, and offices participating in this transformation, including:

• Governor’s Office
• Department of Healthcare and Family Services (DHFS)
• Department of Children and Family Services (DCFS)
• Department of Human Services (DHS)
• Department of Aging (DOA)
• Department of Public Health (DPH)

For more information, click here.

Integrated Health Home has core values because it is responsible for care coordination of members. This vision will affect Illinois health systems and includes:

• Fully developed and coordinated care (including physical, behavioral and social needs for the members of Illinois Medicaid)
• Various forms of services for members who require the highest levels of coordination
• Comprehensive coordination for Illinois Medicaid members with chronic conditions
• Collaborative agreements with various different entities and service providers in order to ensure proper coordination of the services provided   

Integrated Health Homes in Illinois will ensure that members with the highest needs have high intensity care coordination and opportunities to enhance these needs. It will identify enhanced support to help families manage complex needs, such as housing and justice systems.

What are the Expected Benefits?

Integrated Health Homes in Illinois healthcare focuses primarily on the coordination of care. Integrated Health Homes are primarily designed for Medicaid members except for those individuals with technical exclusions, such as members who have partial benefits or members with high third-party liabilities.

Main goals for members and families

The fully integrated plan will ensure that providers take a holistic view in order to meet the members’ needs. Comprehensive care plans will also be provided to support ongoing communication with behavioural and physical healthcare providers. There will also be improved access to routine appointments that can be adversely affected by frequent barriers. There is little continuity in the delivery of care among providers, this element will be improved by assisting in maintaining effective communication plans across the providers.

There is also limited engagement in the care and recovery process.  The Integrated Health Home plan will be designed to provide access and collaboration with community supports. By providing effective treatment programs that focus on self-care, education, and social skill developments, the skills of the individuals will be enhanced.

The 1115 waiver will ensure the effectiveness of high-priority benefits are maximized. The waiver benefits include: supportive housing and employment services, services for individuals with substance use disorder (SUD) with withdrawal management and recovery coaching.

More information can be found here.

The IHH model includes both children and adults in an effort to serve the whole family. However, an issue has been addressed that states the delay of the implementation plan.

What Does the Delay Mean for the Affected Population?

The delay means that individuals will have to wait for the benefits that are offered by the Integrated Health Homes implementation plan in Illinois healthcare. There is limited support for Medicaid members and Illinois would be the first fully integrated Health Home. This delay pushes back the benefits that are expected to help the affected members.

Implementation will begin the first day of the month following adoption of the IHH administrative rules.

Any questions regarding the delay of this implementation can be directed to: [email protected].