Further summary and action plan from Advocates Network

[Guest guest]

Here is the summary and action plan from the previous posting on Managed Care

from Advocates Network...

Ellen

Managed Care Pilot. Lynn O'Shea, CEO of AID, discussed the managed care pilot

proposed by the governor. It is intended to be implemented by July 1, 2010 in 6

metro Chicago counties, including Kane County, but not the city of Chicago. Her

objection is that Medicaid's financial problems regarding aged, blind, and

disabled do not stem from waste, but rather from lack of revenue..

A.Concerns. Seventy percent of service provider funding is from Medicaid. 3,000

people will be affected. Concerns include:

1.Will cost money to hire managed care organization and pay for their expenses

and a profit. States goal is a $1 billion savings and a 10% incentive to

agencies who meet proposed outcomes. But this will be taken out of cash-strapped

budget.

2.Health and Family Services (HFS) has noted inefficiencies and waste. Want to

merge medical and long-term care (i.e., people with mental illness over-use

emergency room care). However, HFS could point to NO waste on the DD long-term

care side.

3.Any cost savings would go to an HMO.

4.HMO would be a barrier between elected officials and voters.

5.Would restrict access to doctors and hospitals—clients would have to stay

within the county.

6.Agencies will be asked to lower group home costs. Will combine residents into

one home—more crowded but same number of staff.

B.Action. O'Shea is asking voters to go to legislators and request:

1.Slow down the process. July 1 is too fast. Look at what has worked in other

states. Managed care HAS brought savings in states where, unlike Illinois, there

was no waiting list (Illinois has 18,000); no state institutions (Illinois has

thousands in institutions); and rates are adequate (Illinois's are not).

2.Carve out DD services from managed care.

3.Research and pilot other models—see what works.

4.Increase revenues—taxes.

[Guest guest]

Here is the summary and action plan from the previous posting on Managed Care

from Advocates Network...

Ellen

Managed Care Pilot. Lynn O'Shea, CEO of AID, discussed the managed care pilot

proposed by the governor. It is intended to be implemented by July 1, 2010 in 6

metro Chicago counties, including Kane County, but not the city of Chicago. Her

objection is that Medicaid's financial problems regarding aged, blind, and

disabled do not stem from waste, but rather from lack of revenue..

A.Concerns. Seventy percent of service provider funding is from Medicaid. 3,000

people will be affected. Concerns include:

1.Will cost money to hire managed care organization and pay for their expenses

and a profit. States goal is a $1 billion savings and a 10% incentive to

agencies who meet proposed outcomes. But this will be taken out of cash-strapped

budget.

2.Health and Family Services (HFS) has noted inefficiencies and waste. Want to

merge medical and long-term care (i.e., people with mental illness over-use

emergency room care). However, HFS could point to NO waste on the DD long-term

care side.

3.Any cost savings would go to an HMO.

4.HMO would be a barrier between elected officials and voters.

5.Would restrict access to doctors and hospitals—clients would have to stay

within the county.

6.Agencies will be asked to lower group home costs. Will combine residents into

one home—more crowded but same number of staff.

B.Action. O'Shea is asking voters to go to legislators and request:

1.Slow down the process. July 1 is too fast. Look at what has worked in other

states. Managed care HAS brought savings in states where, unlike Illinois, there

was no waiting list (Illinois has 18,000); no state institutions (Illinois has

thousands in institutions); and rates are adequate (Illinois's are not).

2.Carve out DD services from managed care.

3.Research and pilot other models—see what works.

4.Increase revenues—taxes.