States experimenting with Medicaid managed care

Some states are seeing managed care as a way to save money on their Medicaid programs, according to news coverage.

Chicago Tribune: "Can Illinois make Medicaid managed care work for some of the state's sickest, most vulnerable residents -- people with serious physical and mental disabilities? Officials are committed to trying as part of a massive overhaul of the state's $14 billion Medicaid program. Things aren't going especially smoothly at the moment ... Caught in the middle at the moment are Medicaid members with disabilities living in suburban Cook county and the collar counties who now don't have a choice: for the first time ever, they are being forced into HMO-style plans, with restricted provider networks" (Graham, 8/26).

The Associated Press/MSNBC: "Leading medical centers have refused to join the cost-saving program starting in six northern Illinois counties. ...The state expects the six-county pilot program to save taxpayers nearly $200 million in its first five years. Two for-profit companies have been selected to run the program: Hartford, Conn.-based Aetna Inc. and Centene-IlliniCare, an affiliate of St. Louis-based Centene Corp." (8/26).

Kaiser Health News: "Medicaid managed care is a risky business. Many new enrollees are older and sicker than the people health plans typically cover. The political environment is fierce, and insurers face resistance from doctors, hospitals and perhaps patients. ... As budgetary pressure rises, states are increasingly passing it on to private plans. Plans typically get a monthly sum to cover a patient's health costs and try to save by cutting wasteful spending, such as an expensive emergency room visit when a family doctor would do" (Weaver, 8/26).