Public Accountability Report Public Accountability Report

2025 Medical Programs
Mission Statement To improve the health of Illinois' children and families by providing access to quality medical care.
Program Goals and Objectives
  1. Improve and maintain access to quality healthcare services.
    1. Increase the percentage of clients receiving care through managed care organizations.
    2. Implement Medicaid expansion authorized by the Affordable Care Act (ACA).
  2. Continue to improve administrative and analytic capability.
    1. Continue upgrade of Medicaid Management Information System.
    2. Continue upgrade of Enterprise Data Warehouse.
    3. Reduce backlog of Office of Inspector General approvals necessary for long-term care enrollment.
  3. Continue to provide more opportunities for rebalancing long-term care services.
    1. Increase share of long-term support and services expenses on noninstitutional services.
    2. Make progress on process management steps necessary to implement the Balancing Incentive Program.
  4. Maximize revenue and improve cost-effectiveness.
    1. Increase recoveries of overpayments within the medical assistance programs.
    2. Maximize federal funding for newly eligible clients under the ACA.
Source of Funds General Revenue Fund, University of Illinois Hospital Services Fund, HFS Technology Initiative Fund, State Coronavirus Urgent Remediation Emergency Fund, County Provider Trust Fund, Care Provider Fund for Persons with a Developmental Disability, Long Term Care Provider Fund, Hospital Provider Fund, Special Education Medicaid Matching Fund, Trauma Center Fund, Public Aid Recoveries Trust Fund, Medicaid Technical Assistance Center Fund, Money Follows the Person Budget Transfer Fund, Illinois Health Benefits Exchange Fund, Medical Interagency Program Fund, Drug Rebate Fund, Tobacco Settlement Recovery Fund, Medicaid Buy-In Program Revolving Fund, Healthcare Provider Relief Fund, Medical Special Purposes Trust Fund Statutory Authority 20 ILCS 2205/2205-5, 305 ILCS 5
Fiscal Year 2026 Target/Projected Fiscal Year 2025 Actual Fiscal Year 2025 Target/Projected Fiscal Year 2024 Actual Fiscal Year 2023 Actual
Input Indicators
Total expenditures - all sources (in thousands) $ 44,889,862.8 $ 38,696,362.9 $ 38,062,841.1 $ 37,913,515.4 $ 34,146,807.7
Total expenditures - state appropriated funds (in thousands) $ 43,188,678.2 $ 38,696,362.9 $ 38,400,103.6 $ 36,339,800.9 $ 34,146,807.6
Average monthly full-time equivalents 1,262.0 1,047.0 1,230.0 1,208.0 946.1
Output Indicators
Number of people enrolled in Medicaid 3,166,846 3,210,077 3,591,065 3,668,333 3,935,468
Number of people enrolled in the ACA 710,951 732,515 830,649 862,774 939,005
Number of adults with disabilities enrolled in the medical assistance program 221,507 217,543 250,383 247,284 250,817
Number of children enrolled in medical assistance programs 1,450,179 1,426,566 1,496,503 1,527,040 1,542,115
Number of seniors enrolled in medical assistance programs 281,437 287,545 293,663 304,943 336,269
Number of all other adults enrolled in medical assistance programs 494,891 545,908 719,867 726,292 867,262
Outcome Indicators
Third-party liability cost avoided per full-time equivalent in third-party liability section (in thousands) $ 39,500.0 $ 39,301.0 $ 34,500.0 $ 34,424.0 $ 31,815.0
Percentage of all seniors and persons with disabilities in managed care 92.00% 92.00% 96.00% 96.00% 88.00%
Percentage of clients in managed care (includes any coordinated care entities, managed care organizations, managed care community networks, or county care) 78.00% 79.00% 79.00% 79.00% 77.00%
Medicaid Federal Financial Participation earned for newly eligible clients under the ACA (in millions) $ 9,109.9 $ 7,625.9 $ 8,429.0 $ 7,813.3 $ 7,783.6
Efficiency/Cost-Effectiveness Indicators
Amount collected from providers for inappropriate actions (in thousands) $ 3,500,000.0 $ 3,559,563.0 $ 15,000,000.0 $ 9,299,937.0 $ 12,472,344.0
Amount of inappropriate claims by clients prevented (in thousands) $ 13,000,000.0 $ 17,815,165.0 $ 130,000.0 $ 133,014.7 $ 37,327,182.0

Looking for more information?