A Medicaid managed care program is a state-run system where government pays private health plans a fixed monthly fee to coordinate care for people who qualify for Medicaid. Think of it like a subscription model: the insurer gets a steady payment to arrange doctor visits, prescriptions and hospital care while managing costs and quality. Investors watch these programs because enrollment size, payment rates and contract rules directly affect health-plan revenues, profit margins and financial risk.
dual eligiblemedical
People who qualify for both Medicare (federal health coverage for older adults and certain disabled people) and Medicaid (a state-run program for low-income individuals) are called "dual eligible." Think of it like someone who has both a full-price warranty and a low-income discount — they get coverage from two programs with different rules and payments. Investors care because dual eligibles represent a large, often costly patient group whose care is paid at different rates and is sensitive to government policy, affecting providers’, insurers’ and drugmakers’ revenues and regulatory risk.
A Medicare-Medicaid Alignment Initiative (MMAI) is a program that coordinates benefits and care for people who qualify for both Medicare and Medicaid, combining coverage rules, payments, and services to reduce duplication and improve health outcomes. For investors, MMAI can change how much managed care plans, providers, and drug makers are paid and how risks are shared—similar to merging two overlapping insurance policies so one company manages costs and care more efficiently, which can affect revenue, expenses, and enrollment trends.
fully integrated dual eligible special needs plan (fide-snp)regulatory
A fully integrated dual eligible special needs plan (FIDE-SNP) is a type of health insurance that combines Medicare and Medicaid benefits into a single, coordinated plan for people who qualify for both programs. Think of it as a one-stop bundle that manages medical care, prescription drugs and long-term support in a unified way. For investors, FIDE-SNPs matter because they concentrate enrollment, government payments and cost-sharing under one contract, which can affect revenue stability, margins, regulatory risk and growth potential for insurers operating in this market.
behavioral healthmedical
Behavioral health covers services, treatments and products that address mental health, substance use and other behavior-related conditions—everything from therapy and counseling to addiction treatment, psychiatric care and digital mental-health apps. Investors care because demand, reimbursement rules, regulation and the effectiveness of treatments directly affect revenue and costs for providers and companies, much like how advances or policy changes in any essential service can change who buys it and how profitable it is.
community health workersmedical
Community health workers are local, trained caregivers who provide basic health education, screening, follow-up and navigation between patients and formal health services, acting like a neighborhood bridge to clinics and hospitals. Investors watch them because they can lower overall healthcare costs, improve patient outcomes and expand access without heavy infrastructure, affecting demand for services, reimbursement models and the performance of healthcare providers, insurers and public health programs.
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LOUISVILLE, Ky.--(BUSINESS WIRE)--
Humana Inc. (NYSE: HUM) has been selected by the Illinois Department of Healthcare and Family Services (HFS) to serve members statewide in HealthChoice Illinois, the state’s Medicaid managed care program. Humana looks forward to supporting Illinois’ goals for health and well-being of the individuals and families it will serve.
For more than a decade, Humana has had the privilege of serving some of Illinois’ most vulnerable residents, caring for dual eligible members who navigate both Medicare and Medicaid through the Medicare-Medicaid Alignment Initiative (MMAI), and, today, the state’s Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) which launched January 1, 2026. HealthChoice Illinois is an opportunity for Humana to extend that same commitment to more individuals and families the state serves, across 102 counties, in continued partnership with HFS.
“It’s an honor to care for more Illinois Medicaid members and their families,” said Samantha Olds Frey, Humana’s Medicaid President in Illinois. “Our goal has always been to provide whole-person care across every generation, from children to older adults, and HealthChoice Illinois lets us do that. We’re grateful for the confidence HFS has placed in us, and we’ll keep working alongside the state, providers and community organizations to improve care and quality of life for the communities who depend on us.”
Humana’s approach reflects HFS’s priorities and commitment to whole-person care. As an active member of the community, Humana has invested in local organizations that address the health-related social needs of Illinois Medicaid members, including maternal health, behavioral health and housing stability:
Maternal Health: Humana is partnering with the Illinois Public Health Association to ease maternal health workforce shortages in high-disparity counties and expand the availability of community health workers to support enrollees.
Behavioral Health: Through collaboration with Southern Illinois University’s Behavioral Health Workforce Center, Humana will help increase workforce capacity in rural and underserved areas. Additionally, Humana is working with Brightpoint to support the Schubert Family Wellness Center in Chicago’s Belmont Cragin neighborhood.
Supportive Housing: Mercy Housing Lakefront, one of the nation’s largest nonprofit affordable housing providers, and Humana are working together to provide transitional housing support and help prevent homelessness among members.
Humana’s HealthChoice plan is slated to go live in January 2027 and looks forward to continuing its partnership with the state of Illinois to deliver meaningful, member-centered care and drive improved health outcomes for years to come.
About Humana
Humana (NYSE:HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell® healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.comand at CenterWell.com.
