Despite questions, Quinn's Medicaid proposal winning some praise
By Kristen Schorsch ; Crain's Healthcare Daily
Crain's) — Gov. Pat Quinn's plan to slash about $2 billion in Medicaid spending is earning cautious praise from some experts, despite questions about whether the cuts would shift the costs of treating the poor to hospitals.
The governor's office Thursday revealed details of Mr. Quinn's February proposal to reduce the state's Medicaid deficit by $2.7 billion. In addition to the cuts, Mr. Quinn on Thursday proposed a $1-per-pack tax increase on cigarettes, which would raise $337.5 million. That additional revenue would be matched by an equal amount of increased federal funding.
The cuts were outlined in a nine-page report that lacked details on some key proposals but still identified 58 categories of savings.
"I would say they've really tried to focus on services where they're going to do the least amount of harm," said Robert Kaestner, a health care economist with the Institute of Government and Public Affairs at the University of Illinois.
Even if half of the proposals were implemented, it would be a good start for the state, Mr. Kaestner said.
Among areas where the Quinn administration expects to find the biggest savings:
> $675 million by cutting reimbursement rates to hospitals and other health care providers.
> $250 million by shifting more of the burden for covering children with special needs to private insurers.
> $120 million by dropping recipients who are actually ineligible for Medicaid.
The proposal comes as the state's backlog of unpaid bills is expected to reach $9.2 billion for the fiscal year ending June 30 and continue to skyrocket, according to a January report by the Civic Federation, a Chicago-based fiscal watchdog group, which praised Mr. Quinn's proposal.
"We started by putting every single thing on the chopping block, and I think we worked backwards to come up with a responsible and balanced approach," said Julie Hamos, director of the state Department of Healthcare and Family Services.
Yet key questions remain about how much the state actually will save and how the cuts would affect providers and patients.
Ms. Hamos acknowledged that the proposed $120 million in savings from eliminating ineligible Medicaid recipients is ambitious.
But the state's monitoring of eligibility "has slipped. . . .We're going to track it much more carefully than it's ever been tracked before," she said.
Mr. Kaestner questioned the reasonableness of those savings, saying he doubted many people are cheating the system.
Some of the proposed cuts are "scary" for a safety-net hospital, said Jose Sanchez, CEO of Norwegian American Hospital in Humboldt Park. Medicaid makes up nearly 70 percent of his budget, he said.
Mr. Sanchez also criticized a proposal to set benchmarks for hospitals to reduce Medicaid readmission rates. The proposal unfairly penalizes hospitals in poor neighborhoods, whose patients are more likely to be readmitted because of factors beyond the hospitals' control.
The state plan, which would be modeled after a Medicare policy that starts in October, saves $40 million, the Quinn administration said.
"Now you have policies that are dictating what the treatment of the patients will be," Mr. Sanchez said.
Ms. Hamos acknowledged that safety-net hospitals are "under great threat." But cuts are necessary to stabilize the Medicaid system, she said.
The $675 million rate cut to providers would be about 8 percent of their reimbursement.
Other areas where the Quinn administration expects to find savings are:
> $136 million, by limiting adult prescriptions to five a month.
> $114.1 million, by imposing a moratorium on new admissions to intermediate-care nursing facilities.
> $72.2 million, by ending Illinois Cares Rx, the Blagojevich administration program that helps about 180,000 elderly, disabled people pay for prescription drugs.
> $51.4 million, by eliminating adult dental care, which would affect around 172,000 people.
> $49.9 million, by reducing the Medicaid eligibility to 133 percent of the federal poverty level, from 185 percent currently, affecting about 26,400 people. Recipients who were grandfathered in under earlier standards would be taken off the rolls.
A representative of the state's nursing home industry blasted the proposed moratorium on new admissions to intermediate-care facilities.
"It's dangerous and I think it's a public safety issue to close the front door on admissions without providing an adequate structure for other places for individuals to reside," said Pat Comstock, executive director of the Springfield-based Health Care Council of Illinois.
In addition to the cut in reimbursement rates, providers likely will end up shouldering even more of the financial burden because patients without private insurance who are ineligible for Medicaid will continue to seek care, experts said.
"Increasing barriers to the services (punishes) the people who have the least resources," said Amber Smock, director of advocacy at Chicago-based Access Living, a nonprofit disability rights and services group.
If approved by the General Assembly, the proposed cuts would be implemented for the next budget year, which begins July 1.
http://www.chicagobusiness.com/article/20120420/NEWS03/120429999/despite-questions-quinns-medicaid-proposal-winning-some-praise
###
Please contact your State Legislators for any concerns with the proposed severe cuts to the State of Illinois Medicaid programs...
No comments:
Post a Comment