All agencies maintain a claims database for billing and federal financial participation (FFP) purposes. Encounter data are maintained for managed care expenditures.
Health and Quality of Life (HEDIS) measures are calculated for all populations in addition to the following:
- Elderly: Supportive Living Record Reviews; Community Care Program Quality Management Report
- Developmental/Intellectual Disability (DD/ID): DD Waiver Performance Measures Report
- Physical Disability: Division of Rehabilitation Services (DRS) WebCM Report (Home Services Program, AIDS, and BI waivers); Supportive Living Record Reviews
All managed care organizations are required to initiate a managed care performance improvement project on an annual basis. Outcomes measures for the DD/ID population are captured through National Core Indicators and an Incident Reporting System, which monitors critical incidents. The Participant Outcomes and Status Measures are used for the elderly population, and the Evaluation of Care Survey for the mental health population.
IL has spent the majority of funds on increasing DD waiver capacity. Mental Health Money Follows the Person ( MFP) coverage, Employment First Initiatives, and Services and Support Teams have been expanded. The funds have also supported improved nursing facility diversions, the Home and Community Ombudsman Program, and peer support drop-in centers. IL plans to invest additional funds in its NWD IT system.