Illinois Capitated Financial Alignment Model Demonstration (Medicare-Medicaid Alignment Initiative)
Guidance for stakeholders on the Illinois Capitated Financial Alignment Model Demonstration (Medicare-Medicaid Alignment Initiative).
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 31, 2020
Illinois Capitated Financial Alignment Model Demonstration (Medicare-Medicaid Alignment Initiative)
SPOTLIGHT & RELEASES
| 04/23/2024: CMS released the Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 8. More information is available below. |
Key Dates
February 22, 2013 - CMS and Illinois sign MOU
March 1, 2014 - Start of opt-in enrollment
June 1, 2014 - Start of passive enrollment
September 14, 2016 - CMS, Illinois, & participating plans execute an updated three-way contract
September 1, 2019 - CMS, Illinois, & participating plans execute three-way contract amendment
July 1, 2021 - CMS, Illinois, & participating plans execute an updated three-way contract
October 1, 2023 - CMS, Illinois, & participating plans execute an updated three-way contract
MMAI Model
On February 22, 2013, the Department of Health and Human Services announced that the State of Illinois will partner with the Centers for Medicare & Medicaid Services (CMS) to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience.
Under the demonstration, also called the "Medicare-Medicaid Alignment Initiative," Illinois and CMS will contract with health plans to coordinate the delivery of and be accountable for all covered Medicare and Medicaid services for participating Medicare-Medicaid enrollees.
More information from CMS:
- Fact Sheet
- Three-Way Contract (Word) (PDF)
- MOU (PDF)
- State Proposal (PDF)
- Third (Preliminary) Evaluation Report for the Illinois capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (04/12/2023)
- Second Evaluation Report for the Illinois capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (09/15/2021)
- First Evaluation Report for the Illinois capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (11/29/2018)
- Readiness Review Tool (PDF)
- Illinois Evaluation Design Plan (PDF)
- Letter of Intent to Extend Scheduled End Date (PDF)
- Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 1 (PDF)
- Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 2 (PDF)
- Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 3 (PDF)
- Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 4 (PDF)
- Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 5 (PDF)
- Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 6 (PDF)
- Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 7 (PDF)
- Illinois Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 8 (PDF)
Information for Plans:
- All state-specific information and guidance for plans is available on the Information and Guidance for Plans page.
Information for Beneficiaries and Providers:
- Illinois Medicare-Medicaid Alignment Initiative Ombudsman Program
- Illinois Medicare-Medicaid Alignment Initiative Provider Frequently Asked Questions (FAQs) (PDF)
- Illinois Medicare-Medicaid Alignment Initiative Continuity of Care Provisions (PDF)
- Illinois Medicare-Medicaid Alignment Initiative and Medigap FAQs (PDF)
- Illinois Medicare-Medicaid Alignment Initiative Pharmacist Provider FAQs (PDF)
Information from the state of Illinois:
Funding Support:
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