Gov. Bruce Rauner’s administration is seeking to offer more Medicaid services through managed-care programs.
Rauner and two cabinet members announced the plan in Chicago Monday. It involves choosing a vendor that’ll provide managed-care services to 80 percent of Medicaid clients.
That’s up from 65 percent now. It’ll also be expanded to all Illinois counties and children in the care of the Department of Children and Family Services.
* But there will be fewer managed care providers…
Rauner inherited managed care from Democratic Gov. Pat Quinn, who backed a law aggressively placing 50 percent of Medicaid enrollees into a health plan that would keep close tabs on their medical care. Now about 65 percent of the state’s 3.1 million Medicaid recipients are in managed care.
While Rauner wants to expand managed care services statewide and add another 15 percent of all Medicaid enrollees to the program, he explained why he plans to cap the number of insurers that can participate to between four and seven.
There are simply too many insurers now participating, he said. While the number has shrunk from roughly 30 to 12 insurers now, the vast system is an administrative headache for doctors, hospitals and patients, he argued. In Central Illinois, for example, enrollees have little access to managed care.
Illinois has been gleaning lessons from other states, including Arizona, which requires all Medicaid recipients to be in managed care. The idea of managed care is to surround patients with teams of nurses, social workers and doctors to coordinate treatment and therefore lower medical costs. […]
Rauner said he couldn’t speculate about how much money the new contracts could save Medicaid, but he said “there’s clearly significant savings to be had” by increasing quality and focusing on prevention.
Rauner wants to take that number of managed care organizations down to as few as four and no more than seven, according to the state’s RFP. Needless to say, some managed care companies are starting to freak out.
And all of this is happening while DC tries to figure out what it’s going to do with Medicaid and the ACA.