Illinois Medicaid begins enrolling 40,000 people in private health plans : May 31, 2011

Chicago Tribune : By Bruce Japsen

Illinois' Medicaid health insurance program for the poor has begun enrolling 40,000 people into two private health plans, the beginning of a broader initiative to provide better coordinated and more cost-effective medical care for some elderly and disabled patients.

The Illinois Department of Healthcare and Family Services, which runs the state Medicaid program for the poor, said today the program will serve seniors and adults with disabilities in suburban Cook, DuPage, Kane, Kankakee, Lake and Will counties. They will have to enroll in a health plans operated by Aetna Inc. or the other private plan contracting with the state that is run by Centene Corp. subsidiary known as IlliniCare.

This integrated care program is the culmination of efforts to increase efficiency in government and improve care for some of the state's most vulnerable citizens," Julie Hamos, director of the state department of healthcare and family services, said in a statement today. "Through this innovative program we will improve outcomes and increase the quality of life for these residents while saving the taxpayers millions of dollars."

For years, the state Medicaid program has offered HMOs as a form of managed care for poor Illinois residents, largely children and parents of those children. But that managed care program has less than 200,000 of the state's more than 2 million Medicaid recipients.

Health plans and observers have long believed the low participation rate is largely because it is voluntary and available in limited areas of the state.

But in Illinois and other states across the country, moves to require more Medicaid patients choose private health plans have gained momentum in the poor economy that has seen state budget deficits grow dramatically. Medicaid, funded by dollars from both the state and federal government, is always a large part of any state budget.

Illinois health officials say the "Integrated Care Program" will save the state about $200 million during the next five years. A statement from the department of healthcare and family services said the state's contracts with Aetna and Centene have "pay for performance measures" that create incentives for the health plans to spend money on "better health and quality of life, while at the same time reducing the cost of the service over time."

There is much riding on the success of the Integrated Care Program's effort with the 40,000 seniors and disabled Medicaid recipients because it will eventually be expanded.

In January, Gov. Pat Quinn signed into law a measure that had support of Democrats and Republicans that will bring "coordinated care" to cover at least 50 percent of the state's 2.9 million Medicaid recipients by 2015.

bjapsen@tribune.com