Rep. Patricia Bellock's (R-Hinsdale) concern for Illinois managed care is more than apparent.
Attending the third House Appropriations-Human Services Committee hearing in less than a month, the deputy Republican leader questioned the $60 billion Managed Care organizations (MCOs) and commercial insurance revamp plan to increase managed care to Medicaid patients.
Monday she questioned Milliman Principal Consulting Actuary Robert Damler on real-time pharmacy data.
“When you originally gave your remarks on how you came to your financial expertise on this issue, you said most of your information was on 2016, but you did go into 2017,” Bellock said.
“Next year when we are setting the rates, we will get much more information as far as the calendar year of 2017,” Damler said, adding while watching the 2016 data emerge it revealed an interesting low trend rate this year. “There is seasonality in the first six months of the year where they are slightly higher than the next six months of the year, and you also need to take into consideration a lot of the claims have not been paid yet.”
At the first hearing and second hearing, Bellock discussed resolving the 2011 N.B. v Norwood lawsuit, which was brought against the state for not providing sufficient behavioral health care to adolescents and the importance of consent decrees. This time around, Bellock brought all of her concerns full circle since the contract needs to be finalized in the next couple of weeks.
“The whole point of going out and changing the system again and reducing the amount of providers was to improve the managed care system in Illinois,” Bellock said.
She said after studying MCOs across the U.S., Illinois lawmakers have focused on the most productive plans in order to bring the best forward for Illinois.
“Everybody in the United States is in some form of managed care now, whether it be a PPO or an HMO," Bellock said. "Our point was to take people out of emergency room services and help people have a primary care physician."
Bellock specifically noted her work with Rep. Carol Ammons (D-Champaign) on mental health and substance abuse parity compliance.
“That is an important issue because we know it is key,” Bellock said of the issue that has also been a concern in the MCO revamp plan.
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