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Welch demands consequences, including bans, for miserable failure to reach contracting goals

Monday, Aug 10, 2020

* After weeks of prodding, HFS finally released the racial data for Medicaid managed care providers. And the results are not pretty. Press release…

State Rep. Emanuel “Chris” Welch, D-Hillside, is calling on Illinois Medicaid providers to face consequences for failing to meet fair contracting goals for businesses owned by racial and ethnic minorities and women.

“As the largest health insurance program in Illinois, Medicaid offers the ability for the state and its health care partners to demonstrate a commitment to equity and inclusion in contracting for services,” Welch said. “Unfortunately, most providers in the Illinois Medicaid program have failed to meet fair contracting goals. This failure is a disservice to the patients served by Medicaid, the health care professionals that serve those patients, and all the people of Illinois.”

The Illinois Department of Healthcare and Family Services (HFS) recently released fair contracting data for Illinois Medicaid providers after a request by Welch. The six Medicaid providers for the state, Blue Cross and Blue Shield, CountyCare, IlliniCare, Meridian, Molina, and Next Level, met just 52% of their combined fair contracting goal. Only one of the six providers, IlliniCare, met or exceeded fair contracting goals. Without the inclusion of IlliniCare, the other five providers met less than 40% of their combined fair contracting goals.

Welch is demanding that HFS explore penalties against Medicaid providers for failing to meet fair contracting goals. Penalties could include clawing back money paid to the providers, fining the providers, or banning them from doing business with the state.

“Economic justice is a critical aspect of racial justice and the goal of fair contracting standards is to advance economic justice. Unfortunately, most health care providers in Medicaid are failing to meet fair contracting goals and failing to meet the urgent need for economic and racial justice,” Welch said. “The health care providers that have failed to meet contracting goals for Medicaid need to face consequences for their lack of commitment to economic justice and fair contracting.”

* Click the pic for a larger view, but take a look at these numbers

CountyCare is run by Cook County. I cannot imagine how President Preckwinkle justifies those numbers. An $18.8 million goal and Black-owned businesses make up less than a million bucks?

And does it look to you like Molina is even trying?

This is not some new program that was foisted on companies a few months ago. HFS needs to crack down hard on managed care groups that don’t or won’t live up to statutory expectations. And the maximum allowable $100,000 fines will be just a drop in the bucket. I mean, that’s equivalent to the cost of maybe one employee.

Our politicians like to talk a lot about our state’s diversity, yet the state can’t even meet smallish goals on huge multi-billion-dollar programs. It’s just downright shameful.

- Posted by Rich Miller        

20 Comments
  1. - Derek Smalls - Monday, Aug 10, 20 @ 10:32 am:

    Preckwinkle has been on a high profile effort over the last year or so to stress racial equity in Cook County government. The stats show she has her work cut out for her. She just gained more control of the hospital system so time to put words into action.


  2. - Tammy - Monday, Aug 10, 20 @ 10:36 am:

    == Preckwinkle has been on a high profile effort over the last year or so to stress racial equity in Cook County government. ==

    Yep. Physician, heal thyself.


  3. - 40,000 ft - Monday, Aug 10, 20 @ 10:38 am:

    The efforts to publish these results is impressive.

    Why is there a such a disconnect between reality and the promoted image? Managed group think, acceptance of cognitive dissonance, complicit actors, etc?

    Keep up the pressure.


  4. - Helm - Monday, Aug 10, 20 @ 10:43 am:

    Good on Welch for continuing this fight. He’s made a similar request to Northwestern. Will be interesting to see what those numbers look like.


  5. - Back to the Future - Monday, Aug 10, 20 @ 10:49 am:

    Bridges are now down, ramps are open, streets are quiet and people are starting to come out.
    Can not imagine what would have happen to the area if the CPD had not stood tall. Feeling pretty good about the folks in blue today.


  6. - muon - Monday, Aug 10, 20 @ 10:52 am:

    Without a detailed breakdown it looks like Molina uses a white-female-owned contractor(s) for virtually all their contracting, with a very small contract to a black-male-owned contractor. If they were only judged by the total of female- and minority-owned businesses used as contractors they would look spectacular at 100%. The breakdown shows where the disparities are.


  7. - revvedup - Monday, Aug 10, 20 @ 11:00 am:

    The larger issue is how many WBE/Minority contractors are actually out there who can be hired for any particular need, in a particular area, and provide the required level of service and support. This is not a dig against them, it is simply that many WBE/Minority contractors may not even be in the field, let alone lack the ability to handle servicing major clients, on a statewide basis like BCBS. If there are few qualified contractors/vendors in an area, is it the fault of Molina, for example, that they didn’t have “enough” vendor dollars spent by certain demographic standards?? Did Molina spend “enough” on men-owned businesses? Look at how much was spent on female-owned. But how many male-owned vendors are there anyway? They spent 0 on Asian-owned, but how many Asians that run these enterprises are there in their area?? Otherwise the inevitable cries of racial/gender discrimination arise where none acutally exists.


  8. - Rich Miller - Monday, Aug 10, 20 @ 11:08 am:

    ===it is simply that many WBE/Minority contractors may not even be in the field, let alone lack the ability to handle===

    The companies have had years to develop these contractors. The wait should be over.


  9. - Rich Miller - Monday, Aug 10, 20 @ 11:10 am:

    === may not even be in the field===

    Maybe a valid excuse 20 years ago. Not today. Talking points need to be rebooted.


  10. - Dan Johnson - Monday, Aug 10, 20 @ 11:15 am:

    A small part of the problem that we can fix is incredibly overbroad state procurement rules. The number of certified minority businesses that Illinois recognizes (which is what the Medicaid companies must use since they are state vendors) in Illinois is less than the number of certified minority vendors in the City of Chicago. We make it WAY too difficult to get certified by the State of Illinois and to remain a vendor in good standing with the State of Illinois. The State should simply recognize any minority-owned business certified by any other government agency and we should make procurement much less punitive. That is a major area of reform that we can do. It is only a small part of why the numbers are abysmal, but it is something the state can control. Hopefully in veto session.


  11. - Anyone Remember - Monday, Aug 10, 20 @ 11:20 am:

    “The companies have had years to develop these contractors. The wait should be over.”

    Unless there is a corresponding effort for small businesses not eligible for BEP (the State does have programs to encourage small businesses to bid on government work), that pesky Croson ruling may rear its ugly head.


  12. - Fav human - Monday, Aug 10, 20 @ 11:41 am:

    It looks like BCBS did as good or better than illinicare based on their % numbers.

    But why was the BCBS goal so much lower??


  13. - Perrid - Monday, Aug 10, 20 @ 11:57 am:

    Fav human, what are you talking about? IlliniCare paid out $24.1 million out of a $23.7 million goal, and BCBS paid out $14.6 million out of a $22.6 million goal. The goals were within $1.1 million.


  14. - Perrid - Monday, Aug 10, 20 @ 12:01 pm:

    I wonder what effect state wideness has on this. CountyCare and NextLevel only operate in Cook County, the rest are statewide. It should be easier for Cook and NL to meet the goal, by at least a little.

    Now, I’m sure many contracts don’t depend on physical proximity, like advertising or call centers, etc., but still I’m sure there are black owned businesses in Cook County who would be happy to take their money. Whereas those may be harder to find in southern Illinois.


  15. - Fav human - Monday, Aug 10, 20 @ 12:13 pm:

    BCBS had 76% on 11 million.

    Illini paid more but had a lower percentage. that means their goal was higher


  16. - eyeball - Monday, Aug 10, 20 @ 12:27 pm:

    Aren’t the goals/guidelines intentionally goals/guidelines with no consequences so that they are not quotas?


  17. - Derek Smalls - Monday, Aug 10, 20 @ 12:44 pm:

    I agree with Dan Johnson’s point, let’s take a bureaucratic step out of the process if possible. In addition, the state’s procurement system is byzantine on a good day. The post Blagojevich reforms made a complex system even more difficult and spreads out accountability between CMS, the CPOs and the line agencies. Large established groups can handle it by throwing lawyers at it, small businesses and startups are a different story. The compliance cost of being a state contractor is high and not everyone can handle it. Delayed payment cycle doesn’t help either.


  18. - John J - Monday, Aug 10, 20 @ 2:48 pm:

    30 ILCS 575, Sec. 4(d)

    By December 1, 2020, the Department of Central Management Services shall conduct a new social scientific study that measures the impact of discrimination on minority and women business development in Illinois.


  19. - Losing My Edge - Monday, Aug 10, 20 @ 4:59 pm:

    “Maybe a valid excuse 20 years ago. Not today. Talking points need to be rebooted.”

    Maybe check your stats. Sounds like you don’t have much real understanding of the program. There hasn’t been a Medicaid contract for ten years that had a BEP aspect, and last I checked, Medicaid doesn’t need construction workers.


  20. - Anon - Monday, Aug 10, 20 @ 11:10 pm:

    These are tax dollars. Can we please put an acceptable number on how much more taxpayers will need to pay to reach these goals? Is it 50% more 100% more than other qualified vendors ? These are goals not guaranteed subsidies.


Sorry, comments for this post are now closed.


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