In trying to reduce spending on Medicaid, Illinois Gov. Bruce Rauner is targeting a state experiment that aims to do the same thing.
Rauner wants to eliminate $60 million that hospitals and other healthcare groups are receiving from the state to coordinate patient care. While the proposed cuts are only a sliver of the $1.5 billion the new Republican governor wants to slash from financially strapped Medicaid, they are sending waves of anxiety through the state's healthcare industry.
Some of the most prominent healthcare systems in Illinois are betting they can keep patients healthier and, ultimately, save money under initiatives former Gov. Pat Quinn launched the past few years.
Under a Medicaid overhaul Quinn backed in 2011, half of the state's recipients had to be in a managed-care program by 2015. The state has hit that goal, according to a spokesman, though enrollment continues for the 3.1 million Medicaid members in Illinois.
Accountable-care entities are among the biggest managed-care programs. Nine of the entities were launched in 2014, including ones led by Advocate Health Care, North-Shore University HealthSystem and Loyola University Health System. Lurie Children's Hospital in Chicago formed another type of managed-care program, a care-coordination entity for children with complex needs such as cerebral palsy.
The state is providing the systems with $60 million to better coordinate treatment. That includes building an infrastructure to connect providers electronically and hiring coordinators to help identify high-risk patients. Eventually, the state would pay the groups a fixed amount of money per patient per month. The groups would generate revenue by sharing with the state any savings achieved by keeping patients well. But Rauner is urging the state's General Assembly to eliminate the funds July 1, as much as two years ahead of schedule. —Kristen Schorsch, Crain's Chicago Business