Governor Bruce Rauner signed into law legislation on the redesign of the Hospital Assessment Program (PA 100-0581) and on Medicaid managed care transparency and oversight (PA 100-0580) on March 12, 2018 at the James R. Thompson Center in Chicago. IHA President and CEO A.J. Wilhelmi and IHA Board of Trustees Chair Bill Santulli, executive vice president and chief operating officer of Advocate Health Care, and Anthony Guaccio, president and CEO of Swedish Covenant Hospital, attended the signing.
Also on hand were Illinois Dept. of Healthcare and Family Services (HFS) Director Felicia Norwood and members of the bipartisan Legislative Medicaid Work Group—Reps. Greg Harris (D-Chicago), Patti Bellock (R-Hinsdale), Sara Feigenholtz (D-Chicago), Robyn Gabel (D-Evanston) and Ryan Spain (R-Peoria), and Sens. Heather Steans (D-Chicago) and Dave Syverson (R-Rockford).
In his remarks, Wilhelmi praised state leaders for their unity and support in passing this legislation. “On behalf of hospitals and health systems across the state, the Illinois Health and Hospital Association commends the Governor, the General Assembly, including the Legislative Medicaid Work Group, and the Department of Healthcare and Family Services for taking action to continue and modernize the Hospital Assessment Program. This essential and vital program, which brings the State $3.5 billion annually, helps ensure that Medicaid beneficiaries and all patients in Illinois have access to the quality healthcare they need when they need it.”
Gov. Rauner also noted his support for the Hospital Assessment Program redesign and improvements to Medicaid managed care. “Our teams worked hard to make sure our most vulnerable citizens can continue to receive quality medical services and to keep hospitals in underserved communities,” Gov. Rauner said. “I’d like to thank all the legislators, state officials and stakeholders who worked to restructure the program. Their unwavering dedication will help keep the Medicaid program sustainable for the future.”
HFS Director Norwood commented on the hard work of key collaborators, including IHA. “This bipartisan legislation took months of extensive negotiation and could never have happened without the support of the Legislative Medicaid Work Group, and certainly not without the support of A.J. Wilhelmi and his team at IHA.”
The next step in the Hospital Assessment Program redesign process is to obtain federal approval from the Centers for Medicare & Medicaid Services.
The assessment legislation:
- Modernizes the assessment program with payments based on updated patient utilization data, replacing current payments based on obsolete data from more than 10 years ago;
- Preserves and rationalizes $850 million in Affordable Care Act funds that the State has secured and maximized for the past four years;
- Moves more than $600 million from static, fixed payments to dynamic claim-based payments—so the “money follows the patient;”
- Recognizes and incentivizes the shift to more outpatient services;
- Includes a process and $263 million fund to assist hospitals in transforming and adjusting to changes in their environment, so they can continue to serve their communities;
- Increases transparency and accountability on Medicaid managed care organization claims processing and payment performance; and
- Sunsets after two years to serve as a checkpoint to evaluate the program’s effectiveness.