 The Chicago Tribune reported Friday that leading medical centers
have refused to join the cost-saving program starting in six
northern Illinois counties.The Tribune report (http://trib.in/nJ6rSU)
said Northwestern Memorial Hospital, Rush University Medical Center
and the University of Chicago Medical Center are among hospitals
that so far have chosen not to take part.
In contrast, the University of Illinois at Chicago Medical Center
has joined the program.
Loyola University Health System said in a statement that it
wasn't participating for now because "our expenses for Medicaid
exceed our reimbursement."
Brent Estes, a vice president at Rush Medical Center, said
managed care plans can force oppressive administrative requirements,
and the plans hunt for ways to restrict payments to hospitals.
Julie Hamos, director of the Illinois Department of Healthcare
and Family Services, told the Tribune she found it "disappointing"
that health care providers were resisting the change.
The state expects the six-county pilot program to save taxpayers
nearly $200 million in its first five years. Two for-profit
companies have been selected to run the program: Hartford,
Conn.-based Aetna Inc. and Centene-IlliniCare, an affiliate of St.
Louis-based Centene Corp.
The pilot program is in the process of enrolling 40,000 adult
Medicaid recipients living in suburban Cook, DuPage, Kane, Will,
Kankakee and Lake counties in managed care.
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"It's been a nightmare," said Suzanne Klug, of Des Plaines, whose
21-year-old daughter, Tamara, has cerebral palsy and severe
developmental delays.
After her daughter was enrolled in the program, she's had to find
a new primary care doctor, surgeon, orthopedic surgeon, neurosurgeon
and neurologist. "It's been endless hassles, endless phone calls,
endless anxiety," Klug said.
Managed care, which grew in the 1990s as states tried to rein in
health care costs, is now the dominant system in Medicaid, according
to the National Academy for State Health Policy.
Illinois has lagged behind other states in adopting managed care,
but a Medicaid overhaul law signed by Gov. Pat Quinn in January will
expand managed care to half the state's Medicaid patients by 2015.
___
Information from: Chicago Tribune,
http://www.chicagotribune.com/
[Associated Press]
Copyright 2011 The Associated Press. All rights reserved. This
material may not be published, broadcast, rewritten or
redistributed.
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