Medicaid Innovation Collaborative to address health needs
Proposed collaboration seeks $137M to address the unmet health needs of Medicaid patients across Illinois
The Illinois Department of Health and Family Services (HFS) has announced that $750 million in funding is being made available over a five year period to focus on community needs, with an emphasis on addressing social and structural determinants of health. The funding will look to improve health and wellness for individuals and communities, tailor solutions to meet the unique needs of specific communities, and invest in projects that improve outcomes, decrease disparities, and are sustainable over time.
In response to this opportunity, OSF HealthCare, in partnership with UI Health Mile Square Health Center (Chicago, IL), Heartland Health Services (Peoria, IL), Chestnut Health Systems, Inc. (Bloomington, IL), Eagle View Community Health System, Inc. (Oquawka, IL), and Aunt Martha’s Health Center (Danville, IL) has applied for over $137 million in state of Illinois Medicaid Transformation funding to be used to support the Medicaid Innovation Collaborative, which will focus on the unmet health needs of some of the most vulnerable populations in Illinois.
The collaboration of Medicaid providers will build a layered approach to care that allows for scarce resources to be maximized in addressing systematic obstacles to better health. The collaborative will utilize the latest tools and techniques in telehealth medicine, pairing them with on-the-ground community-based programs delivered by the Federally Qualified Health Center (FQHC) partners and local community-based organizations (CBOs), creating scalable solutions that can improve access and quality of care for Medicaid patients throughout the state.
By partnering with a combination of FQHCs, CBOs, and other community groups, this collaborative will create an approach to health care delivery that is genuinely responsive to the needs of local communities being served.
Innovative technologies and knowledge gained from the OSF OnCall Digital Health work as the developer of a statewide Pandemic Health Worker (PHW) program during the early days of the COVID-19 pandemic will lay the groundwork for the new initiative. Utilizing a centralized team of caregivers, including physicians, nurses, pharmacists and wellness coaches, as well as resources at the community level, it is expected that more than one million extra touch points of care would be delivered to Medicaid beneficiaries over the next five years.
While OSF HealthCare is the lead entity applying for the Medicaid transformation dollars, our partner entities will be the face of the collaboration in the community.
"OSF HealthCare will support innovative digital models enabling a new level of care for our most vulnerable populations. The FQHCs, using community health workers supported with digital tools and AI technology, will address social determinants of health and the health disparities most prevalent in the communities they serve," explains Michelle Conger, CEO of OSF Digital Health. "While OSF HealthCare is the lead entity applying for the Medicaid transformation dollars, our partner entities will be the face of the collaboration in the community."
Highlights of the Medicaid Innovation Collaborative:
- Potential for approximately 170 new health care jobs spread across the service area
- 1 million episodes of care for Medicaid patients over a 5 year period
- Coverage across a wide geography, with services delivered to potentially up to a third of the state
- Partnership between 5 FQHCs, a dozen-plus CBOs, and three minority-owned vendors
- Solutions provided to address the unmet health needs of vulnerable populations related to behavioral health, mom-baby wellness, and chronic disease management
- Care will be provided in a way that respects the communities the collaborative is serving, is culturally appropriate, and recognizes the challenges and barriers that continue to exist in marginalized communities.
"The Medicaid Innovation Collaborative builds off of every partner's strength," says Henry Taylor, president and CEO of UI Health Mile Square Health Center in Chicago, a network of community-based clinics. "For OSF HealthCare, it is their experience with innovation, analytics, and the deployment of new digital technologies to improve quality and access to care. For us, an FQHC partner, it is our existing relationships with the Medicaid population, our focus on care coordination, and the ability to understand the concerns of the populations we are serving."
In addition to creating greater access to care via the OSF OnCall platform, the collaborative will take immediate steps to improve local access to care.
"The American Dental Association recognizes that the mouth is a window into the health of the body. The Collaborative will significantly expand dental care for Medicaid patients in the Bloomington-Normal area," said David A. Sharar, Ph.D., chief executive officer of Chestnut Health Systems in Bloomington, Ill. "A long-term goal is to expand dental care and improve oral health for patients in counties throughout Illinois."
In the city of Peoria, the collaborative will establish sites in partnership with homeless shelters and other providers of homeless services. These sites are where Community Health Workers can conduct outreach to Medicaid patients, provide digital health services and establish a medical home to address their health needs and provide whatever supportive services possible to manage their social determinants of health.
The collaborative will also look to address transportation in rural areas of Illinois, which continues to be one of the most significant barriers for access to medical care, with plans to provide transportation services for Medicaid patients in need. While one collaborative partner will have an actual van to facilitate transportation, all partners serving rural communities will deploy digitally-enabled community health workers who will serve as a mobile/digital link to the FQHC and OSF HealthCare.
HFS is currently accepting public comments about this and other Medicaid Transformation proposals on its website until April 30.
OSF HealthCare (Peoria, Ill.) is an integrated health system owned and operated by The Sisters of the Third Order of St. Francis, headquartered in Peoria, Illinois. OSF HealthCare employs more than 23,600 Mission Partners in 147 locations, including 14 hospitals – ten acute care, four critical access – with 2,097 licensed beds, and two colleges of nursing throughout Illinois and Michigan. The OSF HealthCare physician network employs more than 1,500 primary care, specialist and advanced practice providers. OSF HealthCare, through OSF Home Care Services, operates an extensive network of home health and hospice services. It also owns Pointcore, Inc., comprised of health care-related businesses; OSF HealthCare Foundation, the philanthropic arm for the organization; and OSF Ventures, which provides investment capital for promising health care innovation startups. More at https://www.osfhealthcare.org.
Aunt Martha’s (Danville, Ill.) Aunt Martha’s is a health and wellness not-for-profit organization serving over 105,000 children and adults throughout over 600 communities in Illinois. Through our Integrated Care Model, we provide primary and family health care, including behavioral health, pediatrics, family planning, parent support, and women’s health. We are also a licensed child welfare provider with foster care and intact family services. Our Integrated Care Center serves to stabilize DCFS involved youth and prepare them for long-term placement.
Chestnut Health System (Bloomington, Ill.) is a private, not-for-profit 501(c)(3) charitable organization governed by a volunteer Board of Directors. Chestnut offers a comprehensive scope of behavioral health and human services in Illinois and Missouri. From drug and alcohol addiction treatment facilities (residential and outpatient) to primary care medical homes, to a research institute, Chestnut continuously works to achieve its mission to make a difference and improve quality of life through excellence in service.
Eagle View Community Health System (Oquawaka, Ill.) Eagle View Community Health System is a Federally Qualified Community Health Center (FQHC). The FQHC is a federal designation assigned to non-profit or public health care organizations that serve uninsured or medically underserved populations. Eagle View Community Health System is a proud member of both the Illinois Primary Health Care Association (IPHCA) and the National Association of Community Health Centers (NACHC) who work to bring community health centers from all backgrounds together to serve a common goal: to provide quality health care services to all, regardless of ability to pay. This clinic opened in 1979 and offers medical, dental, behavioral health care and substance use.
Heartland Community Health Clinic d/b/a Heartland Health Services (Peoria, Ill.) December 10, 1991, Heartland Community Health Clinic started as a free clinic on Monroe Street in Peoria. The first year Heartland Community Health Clinic served 1,000 patients, with one paid staff member. Peoria was a shining example of how a community addresses a community problem that lacks healthcare for the underserved in the '90s, including the working poor, unemployed, and children. When faced with a need for care, many do without because they have no insurance, little or no money, and are ineligible for government assistance programs. In 2004, Heartland Community Health Clinic became a Federally Qualified Health Center (FQHC). In 2016, Heartland Community Health Clinic rebranded as Heartland Health Services, employing over 200 employees, operating eight locations in Peoria and Tazewell County. Heartland's integrated model of care provides primary care, behavioral health services, women's health services, pediatrics, pulmonary, and an array of specialty services. To learn more, visit www.hhsil.com. “Providing high-quality healthcare services accessible for all”.
UI Health Miles Square Health Center (Chicago, Ill.) opened its first neighborhood clinic in 1967 and keeps working to help Chicagoans. Our health clinics are located in many neighborhoods across Chicagoland to care for families at every stage of life. We care for nearly 40,000 people a year - whether or not they can pay for it. No matter your race, religion, or income, you can get care from one of the most respected health systems in the country. Mile Square makes getting health care as easy and comfortable as possible. Over the last 50 years our primary service area has grown to cover most of the west and south sides of Chicago, and includes almost 25% of the City's population, while extending additional services to a site in the suburb of Cicero. Mile Square employs 150 member staff and will provide about 74,000 encounters to more than 24,000 patients this year.