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Cook County health system inks contract
Costs to be covered by federal government over 5 years

Sunday, March 30, 2014
Chicago Tribune
by Hal Dardick

The board running Cook County's public health system on Friday approved a contract worth up to $1.8 billion over five years to manage health care for an estimated 115,000 low-income residents as the county adapts to the federal Affordable Care Act.

IlliniCare Health Plan Inc., a division of St. Louis-based Centene Corp. that already manages health care programs for the state of Illinois, was chosen to operate the CountyCare program. Through CountyCare, people receive either Medicaid or insurance subsidies via the Affordable Care Act, which has come to be known as Obamacare.

The Cook County Health and Hospitals System, which so far has enrolled more than 87,000 people in Medicaid through CountyCare, now either delivers care through its hospitals and clinics or directs patients to other qualified facilities.

Under a new system that goes into effect July 1, the county also will essentially take on the role of an HMO, managing health services provided through CountyCare. Tens of thousands more people are expected to be accepted into CountyCare.

Although the county will take on the financial risk of insuring patients, it is expected that the federal government will cover the entire cost of the five-year contract through Medicaid payments or health care subsidies under Obamacare, said Dr. John Jay Shannon, recently named interim director of the Health and Hospitals System.

More than 88 percent of the money to be paid to IlliniCare will cover the costs of health care, including doctors' fees, prescription payments, nurses' pay and the like. The rest will cover the administrative costs of overseeing the system, said Steven Glass, executive director of managed care for the Health and Hospitals system.

As the county has been enrolling people in CountyCare under a "demonstration program" during the past year or so, many of the services to be overseen by IlliniCare were being handled by three other companies. Starting July 1, those services will be consolidated and run by IlliniCare.

IlliniCare was chosen in part because of its track record overseeing similar systems for the state, and its parent company's track record doing similar work in other states, Glass said.

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