Advocates to Lawmakers: Illinois Should Slash Medicaid Managed Care Organizations from 12 to 5

(Springfield, IL) – At a public hearing before state lawmakers last week in Springfield, Illinois’ top behavioral healthcare advocates recommended that the state reduce the number of its Medicaid Managed Care Organizations under contract from 12 to five.

At a joint Illinois House public hearing on Thursday of the chamber’s human service committees about the Rauner Administration’s plan to reform the state’s $9 billion Medicaid program by, in part, reducing the number of Medicaid Managed Care Organizations under state contract, Community Behavioral Healthcare Association of Illinois CEO Marvin Lindsey told House lawmakers during the four-hour hearing that because of “enormous amount of administrative burden” placed on community behavioral health providers that any new state contract should limit Managed Care providers to “five.”

“Currently, many of our members contract with as many as 7 to 10 Medicaid MCOs, which creates an enormous amount of administrative burden on providers of all sizes, especially small- to moderate- size providers,” Lindsey told legislators. “We support reducing the number from the current number of 12 to 5 to allow providers to focus more time and energy on providing care and treatment instead of being on the phone trying to track down staff from 7-10 MCOs to get authorizations, answers to billing questions or explanations for denied services.”

Under the Rauner Administration’s slated contract “Request for Proposal,” the new Medicaid program calls for more than 80 percent of Medicaid beneficiaries to receive services through managed care, up from 65 percent today. It also extends managed care to every county in Illinois and to children under the care of the Department of Children and Family Services. The new program is scheduled to become effective January 1, 2018.

Today, approximately two million of the state’s 3.1 million Medicaid members are served by managed care plans. But providers and plans have withdrawn from the program in recent months; leading to several counties in central Illinois without any managed care options.

“We support Governor Bruce Rauner’s intent to reduce the number of Medicaid Managed Care Organizations because community behavioral health providers are consumed by navigating a mish-mash of vast, uncoordinated corporate bureaucracies,” said Lindsey. “Those corporate bureaucracies are distracting us from for our core mission: delivering care to individuals working to recovering from mental illness and drug addiction.”


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