Sen. Heather Steans, a Chicago Democrat who chairs the committee, was among the group of lawmakers who pushed for shifting to a managed-care model for Medicaid. But she said Tuesday that there have been signs the new model isn’t working as planned, and that the MCOs have actually been controlling costs by denying claims.
“The history we’ve had with the MCOs has been much more (about) denials, not providing care,” she said.
Eagleson, a former executive director of the Office of Medicaid Innovation at the University of Illinois system, acknowledged earlier in her testimony the agency was “deeply aware” of concerns about denial rates, late payments and other issues in the program. But she also said there are indications managed care is achieving some of its goals.
″… We’re seeing anecdotally things like increased assessments of behavioral health needs, decreased hospital admissions, decreased (emergency room) utilization,” she said. “So we do think that the statistics are going in the right direction in most cases, but we’d like to bring more transparency to you around those issues as well.”