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Illinois’ Managed Care Revamp Delayed

by Kristen Schorsch

Illinois has pushed back the timeline to award lucrative contracts to insurers who oversee most of the state’s Medicaid enrollees.

The Illinois Department of Healthcare & Family Services, which implements Medicaid, is evaluating bids submitted by nine insurers that are vying for a piece of potentially $9 billion in contracts for the state’s Medicaid managed care program.

The state planned to award contracts around June 30 but wants to take a few more weeks to review the bids, said John Hoffman, a spokesman for the department.

“We remain fully committed to this reboot of managed care to ensure sustainable program costs without compromising quality or access,” Hoffman said in a statement.

In an interview, he said the delay is not related to calls from some public officials, including Illinois Comptroller Susana Mendoza, to slow down what could be the largest procurement in Illinois’ history amid an epic budget impasse. The state hasn’t had a budget in two years as Republican Gov. Bruce Rauner and the Democrat-controlled General Assembly tussle over forging a deal.

Twelve insurers currently participate in Medicaid managed care, where they oversee the treatment of about two-thirds of the state’s roughly 3 million Medicaid recipients. These include some of the largest local and national insurers, such as Blue Cross & Blue Shield of Illinois, Molina Healthcare and Aetna. Not every insurer has submitted a bid to potentially return to the program, including Family Health Network, one of the largest Medicaid managed care health plans in the state.

Rauner announced in February that he wanted to overhaul and grow the program to squeeze out more savings. In managed care, doctors and other health care providers keep close tabs on patients to coordinate their treatment, aiming to improve their health and ultimately save money.

Source: Modern Healthcare

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