More employer groups are offering high deductible health plans as the sole offering to their employees due to recessionary pressures. Employers are banking on these plans as ways to save on health care costs. Illinois has awarded Aetna and Centene contracts to adminster the Medicaid Integrated Care Program. The program will attempt to improve health care oucomes through the utilization of medical homes and pay for performance. Many Medicare Advantage private fee for service plans will be disappearing from the market in 2011. Humana, in particular, has kept most PFFS plans in the market and is also marketing a new prescription drug plan that is co-branded with Wal-Mart. The state of Illinois will require employees on its health plans to try certain generic or low-cost brand drugs before more expensive non-formulary drugs will be approved. Accountable Care Organizations are starting to form in the Heartland region. CIGNA will team up with St. John's Mercy Medical Group in Missouri and Blue Cross and Blue Shield of Illinois will partner with Advocate Health Care.