IL Medicaid Managed Care: A Physician Survey

The state’s initiative to transition the majority of Illinois Medicaid patients to managed care organizations (MCOs) is causing significant confusion and unease among health care professionals and patients.

As a result, ISMS conducted a survey of physicians’ views on the subject. The survey findings show that in order to expand patient access and reduce physician burdens, Illinois’ Medicaid managed care system needs:

• A common credentialing system, to reduce hassles and duplication of effort by busy physicians;
• A baseline state-maintained drug manual, to protect patients by requiring MCOs to abide by the coverage guidelines and product offerings included on the existing Medicaid drug manual and preferred drug list;
• Greater transparency, including reliable staff contacts within the MCOs, to help physicians determine patient eligibility, clarify complex issues, and discuss coverage of medically necessary treatment and drugs; and
• Widespread public reporting on the quality and effectiveness of MCOs.

We have shared these results with policymakers and other key stakeholders, and will keep you informed about any further developments.