Illinois CMS Form 416 Reports

The Centers for Medicare and Medicaid Services (CMS) annually collects child Medicaid enrollment and utilization data on reports known as “CMS Form 416.” Illinois has completed reports for every year since 1999, allowing insight into utilization trends over time.

The forms initially monitored utilization of three measures: preventive, treatment, and any dental services. Beginning in 2010 four additional measures were added. The formula for calculating utilization also changed in 2010, moving from a count of all persons enrolled who received the service to a count of all people enrolled for 90 continuous days who received the service. We reflect this change as a line break in the charts below.

Illinois Observations:

• Utilization is highest among age groups 6-9 and 10-14, where more than half of children received any dental service in 2016. That tapers to about 20% of children ages 19-20.
• Utilization of any dental services peaked in 2013 after having risen almost every year since 1999. It then dropped nearly 10 percentage points by 2016.
• The percent of children receiving treatment services nearly halved from 28% to 15% in one year from 2007 to 2008. The rate rose to 21% in 2013, but has fallen again to 16% in 2016.
• Children ages 6-9 are twice as likely to receive a restorative service than those ages 19-20.