The program is being run by two insurance companies, Aetna and Centene-IlliniCare and I am guessing the reimbursement rates are at the heart of the issue, what else today? Many patients will need to change doctors and care facilities.
As what happens today with changes with doctors and care facilities, everybody has to get their data together and it becomes a big mess for the patients and the doctors. BD
CHICAGO — Many doctors and hospitals are refusing to participate in Illinois’ pilot Medicaid managed care program, forcing some patients to find new health care providers, according to a published report.
Leading medical centers have refused to join the cost-saving program starting in six northern Illinois counties.
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 hunt for ways to restrict payments to hospitals.
Julie Hamos, director of the Illinois Department of Healthcare and Family Services, said she found it “disappointing” that health care providers were resisting the change.