Illinois' Medicaid managed care rolls fell just over 0.3 percent in November, according to recent data from the Department of Healthcare and Family Services. [Health News Illinois] 

Enrollment in HealthChoice Illinois was 2,534,771 as of Dec. 1, down from the 2,542,981 enrolled on Nov. 1.

Three health plans saw dips in their Medicaid rolls. Blue Cross and Blue Shield of Illinois and CountyCare Health Plan saw slight bumps in their enrollment.

As of Dec. 1, enrollment totals were:

• Aetna Better Health – 353,708 (1.1 percent decrease from Nov. 1)
• Blue Cross and Blue Shield of Illinois – 709,986 (0.1 percent increase)
• Molina Healthcare – 297,234 (0.3 percent decrease)
• CountyCare Health Plan (Cook County only) – 418,697 (0.5 percent increase)
• Meridian Health Plan – 722,324 (0.8 percent decrease)

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Illinois lawmakers underestimated the cost and demand for the two healthcare programs that provide Medicaid-like coverage for certain undocumented adults, according to a report released Wednesday by Auditor General Frank Mautino. [Health News Illinois]

The programs have cost the state $1.6 billion since the one for those 65 and older launched in December 2020. The second program, which covers adults between 42 and 64, launched in 2022.

The report said that while the initial estimated number of enrollees for the senior program was 6,700, that number grew to 15,831. Estimates for the other program were 26,800 enrollees, but the actual number was 53,936.

The actual cost of the senior program between fiscal years 2021 and 2023 was $412.3 million, a figure the audit said was 84 percent higher than anticipated.

The other program's cost during those three years was $485.3 million, a nearly 284 percent increase over the expected cost.

An analysis of enrollees found more than 6,000 individuals in the programs who were listed as “undocumented” despite having a Social Security number, and more than 400 enrollees lived in the U.S. long enough to qualify for the Medicaid program.

The audit also found nearly 700 enrolled in the senior program were younger than 65.

The Department of Healthcare and Family Services, which oversees the programs, told the Auditor General that, as of this January, it had removed 21,362 enrollees through its redetermination process. 

There were 19,872 enrollees removed for eligibility or procedural reasons, and another 1,490 were removed and enrolled in another healthcare program.

The report recommends that HFS and the Department of Human Services collaborate to remove unnecessary duplicate enrollees and develop controls over eligibility determinations.

The audit comes a week after Gov. JB Pritzker announced a spending plan that removes funding for the program that serves those under 65. His proposal allocates $132 million for the senior program, though new enrollment will remain paused.

He told reporters at an unrelated press conference Wednesday that the report does not reflect the challenge of people’s immigration status changing during a year, nor the redetermination effort to clean up enrollment.

“Some of those people become ineligible mid-year, and you’re still paying for them because we don’t know and maybe they don’t know that they’re no longer eligible for that program,” Pritzker said.

Republicans said the report shows the need to create more transparency around how the Pritzker administration spends on agency initiatives, specifically those related to undocumented individuals.

“What this (audit) truly does show is, while this was a good press pop for a governor trying to get more recognition on the national stage, he was unable to be trusted by the taxpayers of Illinois to actually manage and run this program properly and within cost estimated and associated to the program,” said Senate Minority Leader John Curran, R-Downers Grove.

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For comparison, state lawmakers are grappling with funding mental health systems, rewriting standards for involuntary commitment and strengthening mental health parity requirements. [Becker's Behavioral Healht]

Here are seven state behavioral policy updates to know: 

1. Maryland behavioral health providers and other advocates are urging lawmakers to reverse course on a proposed $116 million cut to funding for the 988 lifeline and other state mental health services, NPR affiliate WYPR reported Feb. 25. 
   
   
2. Massachusetts Gov. Maura Healey halted plans to close two state behavioral hospitals. More than 14,000 community members petitioned the governor to scrap the plans. 
   
   
3. New Mexico lawmakers passed legislation that would establish a trust fund to pay for mental health and substance use programs in the state, the Santa Fe New Mexican reported Feb. 21. Lawmakers also passed a bill to establish region-specific plans for local behavioral health needs, while a third bill to allocate additional funding has yet to receive approval from the state's House of Representatives.  
   
   
4. Connecticut legislators have revived a bill that would allow the state's insurance commissioner to penalize insurers for failing to comply with mental health parity requirements, CT Mirror reported Feb. 18. State lawmakers introduced similar legislation in 2024, but the bill failed to move forward. 
   
   
5. The Colorado House of Representatives passed a bill to strengthen mental health parity enforcement in the state, according to a Feb. 10 news release from the Colorado House Democrats. The bill is awaiting approval from the state's Senate. 
   
   
6. New York Gov. Kathy Hochul has proposed updating the state's involuntary commitment law to allow hospitals to involuntarily admit individuals at substantial risk of harm due to an "inability to meet basic needs," according to a Jan. 14 news release. The change would bring New York in line with other states, and clarify that individuals do not need to present imminent risk or recent overt harmful acts to be involuntarily committed to mental health treatment. 
   
   
7. Oregon lawmakers are also considering changing the state's standards around involuntary commitment. A bill backed by the National Alliance on Mental Illness would allow individuals at risk of harm within 30 days or unable to meet their basic needs to be committed to mental health treatment, CBS affiliate KOIN reported Feb. 19.

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The rapid adoption of AI, the integration of dental and healthcare professionals and the vast ownership opportunities are just three of the many things that have dentists and dental industry executives excited about the future. 

The 22 leaders featured in this article are speaking at Becker's 2025 Fall Future of Dentistry Roundtable, set for Sept. 29 and 30 at the Hyatt Regency in Chicago.

[This article is highlighted for our dental ACHIEVE students, board members and Fellows in the dental space. 

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The Covid-19 pandemic illuminated a vast landscape of misinformation about many topics, science and health chief among them. [Chicago Health]

Since then, information overload continues unabated, and many people are rightfully confused by an onslaught of conflicting health information. Even expert advice is often contradictory.

On top of that, people sometimes deliberately distort research findings to promote a certain agenda. For example, trisodium phosphate is a common food additive in cakes and cookies that is used to improve texture and prevent spoilage, but wellness influencers exploit the fact that a similarly named substance is used in paint and cleaning products to suggest it's dangerous to your health.

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A new analysis of long COVID patients has identified five distinct subtypes that researchers say will help doctors diagnose the condition.[MedScape]

The new five-type index, developed by federal researchers with the National Institutes of Health’s RECOVER COVID Initiative, identified the most common symptoms in 14,000 people with long COVID, with data from an additional 4000 people added to the updated 2024 index.

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Call for Speakers- Call for Speakers- IOMC Maternal & Child Health Symposium Due 2.26.2025. 

Here are the areas of interest, and other ideas are welcome. 

• Medical Perspectives
• Social Determinants of Health
• Advocacy in Maternal & Child Health
• Public Health & Policy Implications
• Payors Perspectives (Insurance & Healthcare Finance)
• Transportation & Accessibility Issues

Please prepare a concise one-page proposal stating your speaker(s), title, organization name, and 50-word abstract (max.) for your topic, and contact information fo  consideration. Please send your information to mchsymposium@iomc.org  

Sponsorships Opportunities 

Sponsorships available, contact us @   sponsorship@iomc.org.

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Value-based care in behavioral health is finally starting to catch up to other areas of healthcare, according to Stuart Lustig, MD, national medical executive for behavioral health strategy and product design at The Cigna Group.  {Becker's Behavioral Health] 

There are several barriers that make it difficult to shift away from fee-for-service payments in behavioral health, Dr. Lustig said. Among them are slower adoption of electronic medical records, a reluctance to measure outcomes and challenges bringing mental health providers into payer networks. 

"All of that has been changing in recent years. More provider groups have gotten bigger, have gotten electronic medical records and have built in the ability to analyze those records and report out on what's happening at an individual level and a population level," he said. 

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In recent years, the United States has seen an onslaught of legislation aimed at dismantling diversity, equity, and inclusion (DEI) initiatives in higher education, including medical education.1

Although these legislative actions are often construed as focusing only on race, they also explicitly or implicitly target members of sexual and gender minority (SGM)  groups. The deluge of legislative and policy attacks, including a slew of executive orders in the current administration, is a component of a larger political movement that seeks to exclude people who have been historically underrepresented and marginalized in many sectors of society, including medicine. These policies threaten the composition and integrity of the health care workforce and will ultimately worsen the health of the populace. 

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....Health care spending in the US totaled $3.8 trillion in 2019 and is projected to reach more than $7 trillion by 2031.¹ Within the US, spending varies dramatically across states, although many key drivers of health care spending, such as access to care, service prices, disease and injury prevalence, and underlying need for health care, vary at more local levels.^2,3 Understanding how health care resources are distributed across counties, types of care, and health conditions—and identifying the payers funding this care—is essential to informing policy decisions and driving areas of further research. [JAMA}

Currently, most local and disease-specific estimates of US health care spending are incomplete or out of date. Estimates of health care spending are available at the national level through National Health Expenditure Projections¹ and at the state level through State Health Expenditure Accounts,^3,4 but these estimates are broken down only by type of care and payer. Disease-specific spending estimates are available for certain conditions, such as diabetes⁵ and Alzheimer disease,⁶ but typically only for select years and most often for the US as a whole. Health care spending reports are also available for specific payers, such as employer-sponsored insurance⁷ and Medicare,⁸ but they lack further disaggregation. Previous work from the Institute for Health Metrics and Evaluation’s Disease Expenditure Project has contributed to a more complete understanding of health care spending in the US: decomposing changes over time into key drivers of spending increases,⁹ attributing spending to modifiable risk factors,¹⁰ assessing spending effectiveness,¹¹ and considering spending and utilization (eg, the number of visits, admissions, or filled prescriptions) differences by race and ethnicity,¹² but in all of these cases, the analysis was conducted at the national level and is not detailed enough to provide a comprehensive view of health care spending.

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