Today’s number: 1.4 million
Tuesday, Jan 6, 2015 - Posted by Rich Miller
* Tribune…
Illinois has shifted about 1.4 million of its Medicaid recipients into managed care, falling just short of a Jan. 1 goal to move more than 1.5 million into the alternative system of delivering health care. […]
A state law passed in 2011 required 50 percent of the state’s Medicaid population, which has grown to about 3.1 million people, to be enrolled in a managed care plan by the start of 2015. Nearly all of the 1.4 million people who have moved to managed care have made the switch in the past year, with nearly half of them switching in the past two months, according to enrollment totals posted on the Department of Healthcare and Family Services website.
Officials plan to enroll an additional 800,000 people in managed care by spring, for a total of about 2.2 million enrollees, said Jim Parker, acting administrator of the Department of Healthcare and Family Services’ Division of Medical Programs. The state has focused its efforts on the most densely populated counties, where there are more hospitals, doctors and specialists than in rural areas, Parker said. […]
Rep. Patti Bellock, a Hinsdale Republican who helped craft the bill, said she is satisfied with the department’s progress.
* Related…
* Top Medicaid official in Illinois to resign: The director of the Illinois Department of Healthcare and Family Services plans to resign Jan. 9 as part of the transition to Republican Gov.-elect Bruce Rauner’s administration. Julie Hamos, 65, oversees the largest state agency and has responsibility for the $18 billion Medicaid program, which pays medical expenses of the poor and disabled, including the cost of more than half the state’s childbirths.
- Excessively Rabid - Tuesday, Jan 6, 15 @ 9:04 am:
I talk to quite a few folks who are on Medicaid and it seems that from the client standpoint, the change to managed care is going pretty well. Haven’t heard any complaints about the process. And if it were me, I’d be a lot happier having a durable regular insurance card than carrying one of the old style paper Medicaid cards.
- Arizona Bob - Tuesday, Jan 6, 15 @ 9:05 am:
Anyone have the metrics on how much this should save per recipient? When I had to switch to a PPO because I was living out of state, I found the program far more expensive than my HMO Illinois plan, and really for no better service.
I would assume someone ran numbers on this before making the change. Anyone know how much this will save from revenues?
- Wordslinger - Tuesday, Jan 6, 15 @ 9:16 am:
Sounds like something’s going right.
- Shark Sandwich - Tuesday, Jan 6, 15 @ 9:44 am:
Bob, you can probably google Il SMART Act for whatever the projections were when they passed it.
- illilnifan - Tuesday, Jan 6, 15 @ 9:53 am:
Bob, on the managed care for persons dual enrolled (Medicaid and Medicare) they are anticipating 1% year one, 3% in year 2;and 5% in year 3. I anticipate that these savings would be similar to other managed care programs for Medicaid. The nice part is the cost is capitated so the state can better anticipate their costs.
- A guy - Tuesday, Jan 6, 15 @ 9:55 am:
Good policy. Keep going.
- haverford - Tuesday, Jan 6, 15 @ 10:17 am:
HFS should be commended for this. Mother Tribune’s original headline for this piece was ridiculous:
“Illinois Medicaid shifts 1.4 million to managed care, missing state goal of 1.5 million”
Glad less pitchforky heads prevailed in editorial.
- walker - Tuesday, Jan 6, 15 @ 10:19 am:
Julie Hamos deserves thanks and praise. This is a tough and thankless job, with big impact on both state finances and people in need. She was taking hits from all sides, and still moved this forward, among many other accomplishments. Bellock is right not to take the political opportunity to criticize.
Best wishes to Rauner team finding someone as good as Hamos has been.
- anon - Tuesday, Jan 6, 15 @ 10:56 am:
I second Walker’s motion to recognize Julie Hamos for the yeoman job she did. Good for Bullock for resisting the temptation for a partisan shot.
- A guy - Tuesday, Jan 6, 15 @ 11:14 am:
I “third” Walk’s motion. Julie has does a great job on this. Repeating: Keep going!
- carbaby - Tuesday, Jan 6, 15 @ 12:05 pm:
On the medical health side this has made very little disruption. However, for the mental health community service world, this has been a year of frustration and aggravation. Each MCO has their own rules and regulations of what medications they will pay for, the level and types of mental health services that can be provided to those with severe, persistent mental illnesses. There has been a complete lack of planning and communication between the Department of Mental Health and all of the MCO’s as well as all of the community mental health organizations in the State. They just recently began having joint meetings with community service providers- however the MCO’s nor DMH had many answers.
- Federalist - Tuesday, Jan 6, 15 @ 12:17 pm:
It will be interesting to see the costs for Medicaid when future state budgets are enacted.
Until then we really won’t know about any cost savings.
Any costs projected now are relatively meaningless. Time will tell.
- VanillaMan - Tuesday, Jan 6, 15 @ 1:11 pm:
Illinois has short-shifted about 1.4 million of its Medicaid recipients into “managed care”…
Fixed.
- Anonymous - Tuesday, Jan 6, 15 @ 1:23 pm:
The move to managed care organizations (MCO’s) is, in some respects, a move away from community based organizations that have been serving these populations for years. The MCO’s are large “for profit” corporations that are not based in Illinois. They provide their services mostly through the telephone. This would be ideal if all of their clients had a working phone and stable housing. Unfortunately, many dual-eligible clients (clients with Medicaid and Medicare) are low-income people, some under 65, often with physical, cognitive or behavioral disabilities. The MCO’s seem to want the cream (client’s that are healthy), but cry and complain when they are faced with the realities of serving clients that have more complicated needs. http://www.modernhealthcare.com/article/20141126/NEWS/311269971
- Left Leaner - Tuesday, Jan 6, 15 @ 1:49 pm:
Hats off to Julie Hamos! I, for one, thought they might get to 1 million if they were very lucky. Glad to be proven wrong.
- DuPage Dave - Tuesday, Jan 6, 15 @ 7:17 pm:
Managed care is wreaking havoc in the home care program for people with physical disabilities as well (run by DHS). As noted above, no one can communicate with the MCOs, who get paid a fee per person although the primary service funding is still carried on the DHS budget. Cost have gone up, not down, and quality of care is lacking. It has been a big charade.
- Bemused - Tuesday, Jan 6, 15 @ 7:22 pm:
Medicaid is paying for half of the childbirths in the state? Disturbing number. If we repeal and replace the ACA does this number go up or down?
- Dj Łódź - Thursday, Jan 8, 15 @ 9:42 pm:
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- Chigaro - Friday, Jan 9, 15 @ 9:12 am:
The concept of managed care for medicaid is sound and most needed. Implementation has not gone well, much of it has been subcontracted to company called Maximus.
Many doctors are still not loaded into the state system after months of waiting, delaying access to many patients and potential loss of their medical home. Patients cannot enroll with their trusted doctors until the system is corrected.
Add to this the dropping of the Federal bump up to Medicare rates and many physicians will opt out of Medicaid.
Well done on the conversion to managed care, but the devil is in the details.