A program for Medicaid patients who have chronic diseases in Chicago is being phased out. It will be replaced with a different program, that covers most of the state, but does not cover people who actually live in Chicago. This change will expand coverage to some people, but will also take away the coverage of people who currently have it.
The current program is called Your Health Care Plus. It is a disease management program designed to help patients who have disabilities and those who have complex illnesses. The purpose is to help these people get the primary medical care they need, and to keep them from having to resort to going to the emergency room or the hospital. The cost of visiting the ER or the hospital is obviously going to be much higher than a regular doctor’s visit.
The Your Health Care Plus program specifically worked with people who were on Medicaid and who lived in Chicago, (but it did cover some people who lived outside Chicago). It handled around 40,000 patients a year, (statewide) and it is estimated that around 58,000 were Medicaid recipients who lived in Chicago, itself.
Soon, the Your Health Care Plus plan will be phased out. It will be replaced with the Integrated Care Program. This new program also works specifically with Medicaid patients who have disabilities, and Medicaid patients who have certain diseases (like diabetes and asthma). This new program will be able to directly treat the Medicaid patients, whereas the previous program could only help them arrange for their treatment.
The Integrated Care Program has already been implemented. It covers around 40,000 people who live in some of the counties that surround Chicago. Specifically, it will help Medicaid patents who live in DuPage, Kane, Kankakee, Lake, and Will counties, as well as the suburban part of Cook county.
In some ways, this is a good thing, because the new program helps more people, who live in a wider area, than the original program did. The problem is that the new program will not cover Medicaid patients who actually live in Chicago, while the older program did help them. This means that a lot of people are about to lose some health care coverage.
There are a few reasons why this change is being made. One is because there is a nationwide trend for states to cut their Medicaid costs by shifting patients into a managed care program. This puts at least a portion of the financial risk on the health care providers, instead of on the Medicaid program.
Another reason has to do with the end of a contract. Health Care Plus was being run by a health care management firm called McKesson Corp., which is based in San Francisco. The firm was paid around $126 million in the first four years of the Health Care Program. The contract that the state has with McKesson is about to end, on June 30, 2011. Therefore, the Health Care Plus program must end as well.
Image by Rhys Asplundh on Flickr