Leading hospitals forgo managed care, burdened by requirements

To balance their cash-strapped budgets and prepare for an additional 16 million Medicaid enrollees under health reform, states are turning to managed care, hoping it will improve care coordination and control costs.

Illinois recently switched its Medicaid program to managed care and will ultimately transfer half of its Medicaid patients into managed care organizations by 2015.

However, several of the state's leading hospitals and physicians are refusing to join the new managed care program, reports the Chicago Tribune.

Institutions including Northwestern Memorial Hospital, Rush University Medical Center, the University of Chicago Medical Center, Children's Memorial Hospital, and Loyola University Health System are citing bureaucratic hassles and cost-cutting measures as reasons for forgoing managed care.

The refusals have forced thousands of chronically ill patients in Illinois to find new providers.

"People are leery," Molina Healthcare Regional Vice President Steve O'Dell said about opposition to managed care in a Kaiser Health News/Washington Post article. "They're worried we're going to clamp down and they're not going to be able to practice medicine like they used to."

Despite resistance, the managed care approach is still making inroads across the nation. California started transferring 380,000 patients into private plans in June while Louisiana debuted managed-care contracts affecting 875,000 enrollees in July, according to Kaiser Health News/Washington Post. And come October, New York will begin switching about 1.5 million patients to managed care.

To learn more:
- read the Chicago Tribune article
- check out the KHN/Post article

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