The National Association of State Chief Administrators (NASCA) announced that the state of Illinois, along with Aetna, has been awarded NASCSA’s 2023 Excellence through Collaboration award.
RICHMOND, VA, September 28, 2023 /24-7PressRelease/ — This award recognizes states that have partnered with a private corporation to implement a program, project or service that positively impacts its service to the state. The nominations are reviewed by experienced state Chief Administrators based on collaboration and value added to the state.
This year’s recipient, State of Illinois partnered with Aetna, for their project “Reforming Retiree Medicare Advantage Program” was recognized on September 19th during NASCA’s award ceremony at the 2023 Institute in Indianapolis, Indiana.
The State of Illinois Department of Central Management Services (CMS) embarked on a transformative journey by transitioning from various HMOs and a PPO to a single Aetna PPO for the Medicare Advantage Prescription Drug (MAPD) provider for retiree medical and prescription drug coverage, effective January 1, 2023.
“During the RFP process, CMS reviewed all the documents provided by each bidder, and found that Aetna offered the richest, low-cost plan, tailored to the needs of our retirees. This plan—the Aetna MAPD PPO plan—will not only save retirees and the State of Illinois money in medical and prescription drug premiums each month, but it will also offer our retirees wider access to support programs—such as Be Well Illinois and Sliver Sneakers—so that the State can continue to focus on the total well-being of our members.” says Cathy Kwiatkowski, Senior Policy Advisor, CMS.
In addition, initial concerns that the implementation of a single MAPD PPO plan would drive members to seek coverage elsewhere were unfounded: enrollment is up, and service requests are down.
Key metrics include:
• Cost Savings: Through the implementation of the single Aetna MAPD PPO plan, the State of Illinois is projected to save approximately $1.1 billion over the next five years.
• Enrollment and Service Requests: Contrary to initial concerns, enrollment in the MAPD program has increased. The number of enrolled members grew by 538 to a total of over 129,000 enrollees. Escalated inquiries or appeals have been minimal, with only 4 out of 15 concerns being overturned by the health plan.
• Inbound Calls and CMS Volume Comparison: Inbound calls to the Aetna MAPD call center decreased over the first quarter, with representatives consistently responding within an average of 4.82 seconds. Moreover, the volume of calls received by the State CMS Medicare team regarding TRAIL enrollment decreased, indicating members’ satisfaction with the plan’s service.
• Aetna Inquiries received by CMS: A small percentage of calls received by CMS were specific to the Aetna MAPD PPO plan, demonstrating members’ overall satisfaction and the declining volume of concerns.
• Operational Efficiency: The transition from manual enrollment to a rolling enrollment process has resulted in approximately $66.4 million in savings over two years. This improvement has eliminated administrative burdens, reduced record adjustments, and minimized annual overtime costs.
“In conclusion, our project exemplifies innovation, strategic thinking, and measurable success in state government operations. By addressing the challenge of fragmented retiree medical and prescription drug coverage and implementing a single Aetna MAPD PPO plan, we have achieved substantial cost savings, increased enrollment, and improved operational efficiency.” summarized Cathy Kwiatkowski, Senior Policy Advisor, CMS.
ABOUT NASCA
The National Association of State Chief Administrators (NASCA) is the leading organization advancing professional development and best management solutions for the administrative functions of state government. The association provides state chief administrators with the opportunity to increase their knowledge of state government administration through education, networking and information exchange on state government trends, leading edge innovations, standards and best practices.
NASCA’s mission is to help state chief administrators and their teams strategically transform state government operations through the power of shared knowledge and thought leadership.
For more information about NASCA’s Awards Program, please visit www.nasca.org.
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