Important Update on Changes in the HFS Medical Programs  

The Illinois Department of Healthcare and Family Services (formerly the Illinois Department of Public Aid) has moved to a Primary Care Case Management model of health care delivery named Illinois Health Connect.  Approximately 1.5 million HFS clients (Medicaid, All Kids and FamilyCare) will be mandatorily enrolled and asked to select a “medical home.”   

PCP recruitment and enrollment:  

Across the state, the Illinois Academy of Family Physicians is working to ensure that members have all the information that they need to make an informed choice about enrolling as a Primary Care Provider in Illinois Health Connect. When PCPs enroll, they are asked to define exactly how many patients they would like to include in their patient panel.  The PCP enrollment statistics as of March 22 for the various regions are shown in the following table:

Although Federally Qualified Health Centers may have several providers, each FQHC is represented as one PCP in this data table.  Recruitment is ongoing in all counties to ensure that all patients have the best medical home possible.  Providers who wish to enroll should call the Provider Helpdesk at 1-877-912-1999 and a Provider Service Representative will make an appointment to come to your office. 

Client enrollment:

Client enrollment for Cook and the Collar Counties began on February 16.  Over 450,000 enrollment letters were sent to families with one or more HFS Medical Program Recipients.  Client enrollment materials have been posted on the www.illinoishealthconnect.com website so physicians and office staff can review them.  Any client who has indicated a Spanish-speaking preference on their HFS enrollment will receive their enrollment materials in Spanish (Most clients do not list any preference). 

Clients who live in Cook County have a choice of enrolling in Illinois Health Connect or a voluntary managed care plan (Harmony or Family Health Network).  The Illinois Client Enrollment Broker will work with those clients to ensure that they have received unbiased information about all of their health plan choices and to help them select the best PCP.  Clients in the Collar Counties only have the option of Illinois Health Connect.  All clients can enroll online, over the phone or by mail.  Bilingual Client Service Representatives are available. 

Cook County :
www.illinoisCEB.com
1-877-912-8880  

Collar Counties:
www.Illinoishealthconnect.com
1-877-912-1999

Clients who do not actively choose a PCP will be auto-assigned to a PCP based on past claims data, PCPs of other family members and geography.  Thirty days after receiving the first enrollment letter, clients will receive a second letter indicating their assigned PCP.  Client then have another 30 days to affirm that choice of PCP or choose a different PCP.

Panel Rosters:  

Very soon, all Illinois Health Connect PCPs will receive their first panel roster in the mail.  Panel rosters can also be viewed at any time via the www.illinoishealthconnect.com website (Click on Provider Access). The current panel rosters only include those patients who have actively selected that PCP as a medical home.  In order to ensure that existing patients are not “bumped” out of a practice by new patients, the computer system preliminarily auto-assigns the existing patients of each PCP. Patients can call and select a different medical home, but until they do, their spot with their current medical home is reserved.  This is intended to preserve continuity of care.  These pending or preliminarily auto-assigned patients are NOT included in the panel roster until their auto-assignment is completely verified 60 days after their enrollment process starts. 

In Cook and Collar counties, the panel rosters for March and April will only reflect those patients who have made an active choice.  The May panel rosters will also reflect patients who have been auto-assigned.  The panel roster includes important clinical information that can be used to coordinate care and also indicates which patients are eligible for disease management services through Your Healthcare Plus.

Physicians who have questions or concerns can all the Provider Helpdesk at 1-877-912-1999 or contact Margaret Kirkegaard, MD, a fellow IAFP member and Medical Director of Illinois Health Connect at 1-888-912-9120 ext 2218 or mkirkegaard@automated-health.com.

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