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This is something that definitely needs expert advice from someone who knows Illinois Medicaid and estate law. A working farm would be considered as an uncountable asset under the laws of some states if significant income was being generated. There would be no reason to make changes in ownership. However, states may differ in their laws, and sometimes decisions of the government can be unpredictable. I would not do anything without first getting expert advice. You could end up shooting yourself in the foot if it is not done correctly. Changing ownership might be the worst thing you could do -- I don't know, since I'm not an expert on these things. 
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The undivided portion of the Medicaid applicant's share might be considered inaccessible as an asset, thus exempt. This is a perfect case for a legal opinion from the proper elder law/Medicaid attorney.
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A big question is if it is a working farm that provides important income for the family. Family businesses have special consideration when it comes to Medicaid. If it is not a working farm, it will be handled as a property that your sibling has interest in.
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This is a question that only your State Medicaid office can answer. Each State manages their own Medicaid programs so what one State does, another State might not.
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Paying the sibling 3 or 5 times that value would seem like a good starting point if the undivided portion of the Medicaid applicant's share is considered an accessible asset. I do hope it is considered an inaccessible one.

Farmland is precious and my worry would be that having it appraised by the wrong person would set its value at what a developer would be willing to pay for it. Farmland is often subsidized and/or granted property tax abatements. But, towns and counties would much prefer to get paid higher property taxes like the ones that come from single family homes and housing developments.

Ask the farm bureau in your area where to start. Perhaps paying the third sibling to give up his/her share of the farm is a good idea if the amount is reasonable and affordable. Do you happen to know how much the farm currently pays in property taxes? Do you know how much the farm currently generates in annual revenue?
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How do they hold title? Jointly, with each having a 50% share? That might factor in. Check the deed, or if you don't have access to it, get a copy from the county clerk's office, register of deeds, or other entity which records property.

I know very little about Medicaid, but it seems to me that the % of ownership would be a factor.

And as FF advises, contact Medicaid to raise the issue, after you've determined how much interest each sister has in the property.
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the state is illinois
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1/3 each but not specific about what part of land went to each
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it is a working farm
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What is the assessed value? In county assessor's records? That is a good starting point. Are there water rights included? Maybe selling portion of water rights would get sibling the value needed so in effect you buying sib out. Get with an attorney well versed in Medicaid and farm/water law.
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