The Illinois Hospital Association (IHA) and hospitals across Illinois recognize that the state faces significant fiscal challenges and that the status quo is no longer workable. However, your editorial on Medicaid reform (“1 in 5 Illinoisans?,” Jan. 31) recycles an outmoded, outdated approach that has been tried before in Illinois and failed miserably ? HMO “managed care” ? which will neither save the state money nor improve health care.
Unlike most other states, Illinois has already employed the main tactics of HMOs, including substantially reducing reimbursement rates to providers. Medicaid’s inpatient-reimbursement base rates for hospitals have been frozen since 1995, with no increases — even for inflation. Outpatient reimbursement base rates are now at levels lower than they were in 1998. As a result, Medicaid continues to pay hospitals in Illinois far less than the cost of providing critical health care services to the growing number of the poor, children, pregnant women, elderly and disabled who rely on our hospitals for care.
The General Assembly was insightful in recognizing the failings of old models of managed care when it recently passed its Medicaid reform legislation. State lawmakers wisely focused instead on more expansive, progressive models that pave the way for performance-based care-management solutions led by hospitals, physicians and other providers. IHA and Illinois hospitals welcome the opportunity to work with the state to increase coordination of care, improve outcomes and reduce unnecessary utilization and costs in the Medicaid program.
Illinois hospitals are committed to ensuring the sustainability of our health care-delivery system in the short term and the transformation of health care in the long-term. That includes partnering with the state to make Medicaid as cost-efficient and effective as possible, while promoting timely access to care with the best possible outcomes.
— Maryjane A. Wurth, president, Illinois Hospital Association, Naperville
