Illinois Medicaid's managed care effort stumbles
Submitted by Illinoisnoki1 on Sun, 09/04/2011 - 20:44
Background: In an attempt to cut costs, Illinois, and other states, have moved to a privatized model for providing Medicaid benefits to the disabled.
Hospitals, doctors resist change;
care arrangements disrupted
It can take years for people with cerebral palsy, autism, schizophrenia or Down syndrome to find trusted physicians to oversee their health. Now, families and advocates say, those medical relationships are being threatened as Illinois rolls out a new program of HMO-style care for people with serious disabilities.
“It’s been a nightmare,” said Suzanne Klug, of Des Plaines, whose daughter, Tamara, 21, with cerebral palsy and severe developmental delays, has been forced to find a new primary care doctor, surgeon, orthopedic surgeon, neurosurgeon and neurologist after being enrolled in the new Medicaid program.
Many doctors and hospitals are refusing to join the new Medicaid program, which the state hopes will better coordinate care and lower costs for some of its neediest recipients. The providers' rationale: They dislike the bureaucratic hassles and cost-cutting measures associated with managed care.
The ranks of those who have said no, for the moment, include prominent medical centers and physician practices with a long track record of serving the disabled, among them Northwestern Memorial Hospital, Rush University Medical Center, the University of Chicago Medical Center, Children's Memorial Hospital and Loyola University Health System.
Because of the situation, hundreds if not thousands of vulnerable, chronically ill individuals are being forced to find new doctors, some of whom appear ill-equipped to handle their needs, according to consumer advocates and families.
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