MM Curator summary
Illinois lawmakers are ready to be done with MCOs.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
SPRINGFIELD – A House committee on Monday advanced a bill that would end the system of hiring private insurance companies to manage the state’s Medicaid program at the end of their current contracts and replace it with a standard fee-for-service payment system.
The bill also calls for a three-year moratorium on any hospital closures or downsizing.
However, it is expected that further amendments to the bill are being drafted, and it was unclear Monday whether a final version could be approved by both chambers of the General Assembly before the special lame duck session ends, either Tuesday or early Wednesday.
That proposal is part of a health care reform package being pushed by the Illinois Legislative Black Caucus, an agenda aimed at addressing racial and ethnic disparities in the state’s health care system.
Medicaid covers more than 3 million people in Illinois, according to the latest tally by the Department of Healthcare and Family Services, and the majority of them are enrolled in a managed care program. Nearly half of those enrollees, more than 1.4 million, are children in low-income families. Another 1.1 million are working-age adults, including more than 640,000 who became eligible with the federal expansion of Medicaid under the Affordable Care Act.
The idea behind managed care was to reduce costs and improve health outcomes by coordinating each person’s health care – making sure they get regular checkups and follow-up visits and coordinating services between primary care providers and specialists.