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* We’ve heard for the past few years that Medicaid managed care would save the state billions of dollars. But now that it’s upon us, providers don’t want to participate in a managed care pilot project for patients with cerebral palsy, autism, schizophrenia or Down Syndrome…
Many doctors and hospitals are refusing to join the new Medicaid program, which the state hopes will better coordinate care and lower costs for some of its neediest recipients. The providers’ rationale: They dislike the bureaucratic hassles and cost-cutting measures associated with managed care.
The ranks of those who have said no, for the moment, include prominent medical centers and physician practices with a long track record of serving the disabled, among them Northwestern Memorial Hospital, Rush University Medical Center, the University of Chicago Medical Center, Children’s Memorial Hospital and Loyola University Health System.
And that means patients who enrolled in the Chicago-area pilot project now have to find new doctors, specialists, hospitals, etc…
Because of the situation, hundreds if not thousands of vulnerable, chronically ill individuals are being forced to find new doctors, some of whom appear ill-equipped to handle their needs, according to consumer advocates and families. […]
“It’s been a nightmare,” said Suzanne Klug, of Des Plaines, whose daughter, Tamara, 21, with cerebral palsy and severe developmental delays, has been forced to find a new primary care doctor, surgeon, orthopedic surgeon, neurosurgeon and neurologist after being enrolled in the new Medicaid program.
* In other news of excellent management and foresight, the RTA hired an outside consultant which posted YouTube videos to inform senior citizens about how their new reduced fare card will work. Trouble is, the RTA failed to include instructions when they mailed out the new cards…
Many seniors have already expressed confusion and frustration over the new cards mailed to them by the Regional Transportation Authority because the cards were not accompanied by any instructions.
“How the devil do these cards work?’’ asked Rita Shafer in an email to the Tribune. “Nothing in the totally useless information provided (by the RTA) tells one how to put money on the card.’’
The RTA didn’t use “smart cards” that can be charged like an ATM card because, they say, they didn’t have enough extra smart cards on hand. So, that means seniors will have to manually charge the paper cards at CTA rail stations, which isn’t great news for bus riders…
Reloading transit cards will create a major inconvenience for the many senior citizens who travel only on buses. They will need to make a special trip to a CTA rail station and walk up or down stairs to the fare card machines.
In addition, the magnetic strip cards are more prone to fail or jam in fare machines than more sturdy smart cards, which are also easier to handle, transportation experts and seniors who use the cards say.
posted by Rich Miller
Friday, Aug 26, 11 @ 3:13 pm
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–Many doctors and hospitals are refusing to join the new Medicaid program, which the state hopes will better coordinate care and lower costs for some of its neediest recipients. The providers’ rationale: They dislike the bureaucratic hassles and cost-cutting measures associated with managed care.–
I didn’t know blowing off the sick because of “bureaucratic hassles” was covered by the Hippocratic Oath. And why would “non-profit” (LOL) hospitals care about “cost-cutting”? They’re not in it for the money, anyway.
Comment by wordslinger Friday, Aug 26, 11 @ 3:27 pm
Probably the saddest part is the specialty providers that used to provide health care services are now choosing not to over the situation.
Comment by Leroy Friday, Aug 26, 11 @ 3:31 pm
I don’t know about in your area, but up here hospitals sure don’t look broke.
Comment by Old Milwaukee Friday, Aug 26, 11 @ 3:47 pm
Nothing like reading the bleeding hearts blog once again. Needless to say medicaid is one of the reasons Illinois is in the mess that itis in today.
Oh well, I am sure the good people of Illinois will find someone to tax more to solve the problem.
Comment by Tired of taxes Friday, Aug 26, 11 @ 3:52 pm
“Trouble is, the RTA failed to include instructions when they mailed out the new cards…”
We’re a paperless society now, Rich. Yay computers!
Seriously, I hope this program has means-testing fully implemented…
Comment by Cincinnatus Friday, Aug 26, 11 @ 3:52 pm
Comment by OneMan Friday, Aug 26, 11 @ 4:01 pm
The future of health care in this great Nation is being revealed to us in these minor vignettes, I’m afraid. The road to sane health care provision is not clear.
Comment by dupage dan Friday, Aug 26, 11 @ 4:11 pm
Problem is, Cincy, the cost of decent means testing will eat into the benefits of increased fare receipts now that the free program has been curtailed.
Comment by dupage dan Friday, Aug 26, 11 @ 4:14 pm
“The providers’ rationale: They dislike the bureaucratic hassles and cost-cutting measures associated with managed care.”
Great: Tail wags dog again. Patient care?
Secondary.
“How the devil do these cards work?’’
Nothing like having a lot of ‘professionals’ handling transportation issues.
Comment by sal-says Friday, Aug 26, 11 @ 4:23 pm
HFS is simply implementing coverage programs that the state legislature demanded. In fact, the GA passed Medicaid reform legislation last year that requires the state to be 50% Medicaid managed care by 2014. It was a centerpiece of the reform.
Comment by Budget Watcher Friday, Aug 26, 11 @ 4:25 pm
Having worked with people with intellectual disabilities for a few decades, I can assure you that finding a doctor to deal with those folks is difficult under any conditions. They can’t tell you their symptoms, can’t accurately answer questions, don’t understand what the doctor wants, might hit, kick, or bite you during a physical examination, or might scream their heads off, and lack a genuine sense of commitment to the process.
As a general rule, they are difficult patients. Complicated patients. When you have a doctor who will treat them in spite of their eccentricities and issues, who will be patient and understanding, you hold onto that doctor and thank your angels that you found him in the first place.
Too many health care professionals want no part of dealing with these challenging and difficult people. Compensate them less, hassle them more, no wonder hospitals and health care providers want nothing to do with this.
I am legal guardian of an out of state relative who has severe disabilities. I’ve been asked many times if I would bring him to Illinois. My answer is always never ever would I do that to my family member. My family member receives good services that are truly tailored to his specific needs. In Illinois, if he could ever get off the waiting lists, he’d be expected to fit into what’s available - whether it meets his needs or not.
This fine quality state that is providing such wonderful services? Michigan. As broke as they are, they do a far better job than Illinois ever has.
Comment by Aldyth Friday, Aug 26, 11 @ 4:27 pm
===Probably the saddest part is the specialty providers that used to provide health care services are now choosing not to over the situation.===
That’s the saddest part? Ok, doc. The saddest part is people aren’t getting the treatment they need.
That said, the focus of this seems to indicate it’s a managed care problem. I’d suggest it’s a profit problem for the providers. You know, gotta have enough for that third house in Aruba.
And I second Word. Non-profit indeed.
Comment by Thoughts... Friday, Aug 26, 11 @ 4:36 pm
Unfortunately, Aldyth, the reason why Michigan may be broke is due, in part, to the wide and deep range of social/medical services they provide coupled with a poor tax base. However, since Illinois’ tax base seems to be getting closer to that in MI, AND Illinois is near dead last in providing care to its’ most vulnerable, you are better off keeping your relative in Michigan.
I am aware of the challanges of being a legal guardian for a disabled adult. Your relative is blessed to have you.
Comment by dupage dan Friday, Aug 26, 11 @ 4:39 pm
You would think these hospitals would be scared of losing their tax exemptions and would agree to accept more charitable work. Or maybe providing the care to free to retain the tax exemption is the outcome of non-participation in Medicare. Hmm.
Comment by Jake From Elwood Friday, Aug 26, 11 @ 5:06 pm
About the consultant with the YouTube videos for seniors. Really. How many seniors who use public transportation are going to be computer users who will check out YouTube? Duh. How much did the consultant get for that one?
Comment by JustaJoe Friday, Aug 26, 11 @ 6:26 pm