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Illinois' economy is tanking along with the rest of the country, and health plans are bracing for losses in membership as banking and manufacturing businesses lay off workers, shut down, or eliminate benefits. The enrollment gains will likely come in the state's Medicaid and SCHIP programs, but insurers are working with small group clients to keep benefits affordable and keep people on the rolls.

Blue Cross Blue Shield of Illinois and its parent, Health Care Service Corp., are exploring value-based benefit designs of various kinds, becoming the third major insurer in the state to focus on incentives for healthy behaviors and drug adherence.

Health plans have responded differently to Illinois' rich state coverage mandate for infertility treatment, and may yet trim back those benefits as the mandate allows.

Health plans are ratcheting up standards in their pay-for-performance programs, adding higher targets to programs aimed at rewarding providers for outcomes.

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