Community Care Alliance of Illinois, NFP Approved as Medicare Advantage Health Plan

Chicago, Illinois (PRWEB) October 01, 2013

The Community Care Alliance of Illinois, NFP (CCAI) has been granted conditional approval as a Medicare Advantage health plan by the federal Center for Medicare and Medicaid Services (CMS).

The approval means that Enrollees of the CCAI health plan - a nonprofit managed- care plan designed exclusively for people with disabilities and seniors on Medicaid – will be able to stay with CCAI when they become eligible for Medicare coverage.

“This is an important step for CCAI to ensure that our Enrollees will be able to enjoy the innovative, consumer-directed, wrap-around Model of Care that we are pioneering under the Illinois Integrated Care Program,” said CCAI President Greg Alexander. “Continuity of care is critical to keeping our Enrollees healthy, independent and active as they age.”

CCAI received federal CMS approval as a Dual Special Needs Plan earlier this year, allowing it to enroll people with disabilities covered by both Medicaid and Medicare.

CCAI was selected by the Illinois Department of Health and Family Services (HFS) to provide integrated care for people with disabilities and seniors covered by Medicaid for the City of Chicago and Winnebago, Boone, and McHenry Counties in the Rockford area. The State of Illinois has set a goal to have 50 percent of all Medicaid recipients enrolled in care coordination by 2015, as required by law. CCAI is the only nonprofit managed care organization participating in the Integrated Care Program.

Achieving positive health outcomes and improving the quality of life for people with disabilities requires attention to the entire spectrum of need. The CCAI Model of Care encompasses six domains of care and support, including long-term care:

•     Medical
•     Functional (e.g. mobility, activities of daily living, memory, problem solving)
•     Environmental (housing, community, transportation)
•     Financial (basic and medical needs)
•     Social Support (friends, family, social groups)
•     Psychological (stress management, mental illness)

To manage each Enrollee’s care, CCAI utilizes disability-competent interdisciplinary-care teams including a primary-care physician or nurse practitioner, a registered nurse care coordinator available 24/7, a long-term services and supports coordinator, and appropriate medical specialists and rehabilitation professionals. CCAI also engages Peer Navigators, people with disabilities themselves who understand the challenges faced by their peers and can offer solutions that help achieve greater independence and quality of life.

Community Care Alliance of Illinois was formed by a group of concerned parties committed to improving the way healthcare is managed and provided to people with disabilities, including:

•     Access Living, an Independent Living Center for people with disabilities
•     Mt. Sinai Hospital and Schwab Rehabilitation Center
•     The Health and Policy Research Group
•     Family Health Network, which has provided managed care for enrollees in the Temporary Assistance for Needy Families (TANF) program for 18 years

Family Health Network (FHN), founded in 1995 to bring quality health insurance to those who need it the most, is the parent company of CCAI. FHN is and has been the only not-for-profit managed care community network serving Chicago and Cook County, and is directed by local healthcare providers. Through years of steady growth, FHN has become a leader in Medicaid managed care serving members with excellent providers and hospitals, as well as proven disease management programs.

Consumer control is a central part of the CCAI model. Two representatives with disabilities serve on the Board of Directors. CCAI has formed a groundbreaking Disability Community Stakeholders Forum in addition to the state-required Consumer Advisory Council. Both are part of the ongoing planning and implementation of services.

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