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After more than a year of preparation, the second
phase of the state’s mandatory primary-care case-management program
was rolled out this week to the remaining counties in central and southern
Illinois, including Sangamon County. Gov. Rod Blagojevich announced the program, called
Illinois Health Connect, in May 2006, saying that people are healthier when
they have a primary-care physician who provides preventive care and regular
checkups. When people who don’t have insurance visit the
emergency department or must be hospitalized, Illinois taxpayers share the
tab. Instead of using the emergency department as the family doctor,
patients under Health Connect are required to have a “medical
home,” through a primary-care physician’s office, which the
state expects to reduce costs.
Several other health-care initiatives still await
action in the legislature. A panel of lawmakers is considering the
governor’s request for administrative changes that would extend
coverage to an additional 700,000 Illinoisans.
“We hope that it becomes
permanent and not just a temporary fix,” says Vince Keenan, a
spokesman for the Illinois Academy of Family Physicians, “but overall
the governor’s approach is heading in the right direction.”
Also, stashed away inside
legislation that prevents health-care providers from prescribing drugs
electronically unless certain conditions are first met is an amendment
establishing a pilot program, requiring some Medicaid recipients to
enroll in one of the state’s managed-care plans. The legislation calls for the participation of as
many as three health plans, although just two Medicaid HMOs — Harmony
Health Plan, owned by Tampa, Fla.-based WellCare Health Plans Inc., and
Family Health Network, a Chicago-area not-for-profit — are operating
in Illinois right now. Medicaid managed care has been slow to catch on
Illinois. As of last month, only 158,662 of the state’s more than 2
million Medicaid clients were enrolled in an HMO, but Illinois Health
Connect is designed to help change that. Phase one of the program’s rollout began on a
voluntary basis last summer. Earlier this year, enrollment was made
mandatory for people in Cook County, the collar counties, and northwest
regions of the state that receive state-sponsored health benefits, such as
the FamilyCare and All Kids programs. Doctors who sign on receive an incentive of $2 to $4
for each patient per month and are guaranteed, in most cases, to be paid
within 60 days of sending the state a bill. For physicians who accept All
Kids, reimbursement from the state is guaranteed within one month; more
than 5,000 doctors have agreed to participate so far. State officials say they don’t believe that the
health-care expansion is taking place too quickly.
“The governor’s office as well as
HFS [the Illinois Department of Healthcare and Family Services] have been
working hard to expand health care, so obviously we think it’s very
good and very important to have these programs in place,” says Teresa
Kurtenbach, an HFS spokeswoman.
Contact R.L. Nave at rnave@illinois.com
This article appears in Sep 6-12, 2007.
