About IAMHP
The Illinois Association of Medicaid Health Plans (IAMHP) was established in 2013 during the state’s transition to a Medicaid managed care model. Today, more than 2.3 million Illinois children, adults, and seniors are served by IAMHP’s member health plans.
Under managed care, state Medicaid agencies partner with managed care organizations (MCOs) to deliver health services to enrollees instead of paying providers directly on a traditional fee-for-service basis. Today, 41 states and Washington, D.C., have managed care arrangements that cover more than 75% of Medicaid enrollees nationwide.
Our Goals
IAMHP and our member health plans work in close partnership with the state and other stakeholders to continuously improve Illinois’ Medicaid program. Together, we strive to create the greatest value for Illinois families who rely on Medicaid to access essential healthcare services. By making the Medicaid program more efficient and effective, we also work to maximize value for taxpayers.
Care
Coordination
Through robust care coordination, health plans build bridges among Medicaid providers to ensure enrollees receive the right care at the right time, in the most appropriate setting.
Quality
Outcomes
MCOs are required to report on and meet nationally recognized quality measures, with financial arrangements built into the system that incentivize preventive care, chronic disease management, maternal health, immunizations, and more.
Cost Containment
and Predictability
Under managed care, the state pays a fixed rate (“capitation payment”) to MCOs, which assume the risk of higher-than-expected medical costs—creating incentives for health plans to control costs and giving the state greater budget predictability.
Our Accomplishments
While our work to make the system better for all stakeholders is never complete, we’re proud of the progress we’ve helped drive to make Illinois a national leader in Medicaid managed care.
Quality
Improvement
Since IAMHP’s formation, our member health plans have guided year-over-year improvement across numerous performance metrics that measure enrollees’ ability to access care and receive high-quality services.
Timelier
Provider
Payments
The managed care model enables the vast majority of claims to be processed within 30 days, helping Medicaid providers get paid faster.
IAMHP Comprehensive Billing Guide and Universal Roster Template
Illinois MCOs collaborate on a shared set of billing practices and enrollment tools that ease the administrative burden on providers. We’re one of a select few states with these resources.
Community
Leadership
IAMHP member health plans partner with businesses owned by minorities, women, and persons with disabilities certified through Illinois’ Business Enterprise Program (BEP)—investing hundreds of millions in these businesses each year.
Program and Policy
Implementation
IAMHP’s collaboration with the state has enabled MCOs to efficiently implement new services, serve new populations, and bring new provider types into the Medicaid program.
For PROVIDERS
- Comprehensive Billing Guide
- Health Plan Information
- Training Opportunities
- IL Dept of Healthcare & Family Services Resources
For HEALTH PLANS
- Care Coordination Fact Sheets
- Training Opportunities
- IL Dept of Healthcare & Family Services Resources
For INDIVIDUALS
- HealthChoice Illinois Information
- Medicaid Member Stories
- IL Dept of Healthcare & Family Services Resources