Similar to Missouri, Illinois also has a state government trifecta – for the Democrats. Governor J.B. Pritzker took office in January 2019 and has been vocal about expanding access to health care. In an effort to improve the state’s fiscal standing, Illinois will increase their state gas tax 130 percent by 2025; the first tax increase generated $100 million in the first month. In the 2020 election, 20 Senate seats and all 118 House of Representative seats are up for election in Illinois. After the results of the 2020 census are complete, Illinois is expected to lose one seat in the US House of Representatives.
Medicaid Managed Care
BJC has struggled for the better part of a year to negotiate contracts with Illinois Medicaid managed care plans. The transition of foster children to managed Medicaid has caused severe case management challenges but the transition for care has been delayed until Feb. 1, 2020. BJC has been working with state officials to keep them informed and supportive of BJC’s objective to have full and fair coverage.
Governor Pritzker signed the Medicaid managed care reform package, approved unanimously in both chambers, into law on Aug. 5. The legislation is designed to stabilize the Illinois Medicaid managed care program and address significant issues in the state’s Medicaid eligibility determination and redetermination processes. It also aims to reduce administrative burden on providers and require managed care organizations to calculate and pay any timely payment interest penalties due to providers in accordance with the “timely payment for health care services” section of the Insurance Code.
A $420 million statewide initiative to guide broadband expansion to help education, telehealth, and economic development was launched by Governor Pritzker in August. The expansion of broadband internet will allow virtual care to expand in rural communities to address the lack of access within those communities.
Illinois virtual care statutes are lacking parity in both payment and service. Without parity laws, health plans can pay for telehealth services at only a percentage of what they pay for in-person services or pay nothing at all. The only law, found in the Insurance Code, states that payers are not required to cover telehealth services; they are only required to meet certain requirements if they choose to offer telehealth services. Parity will allow BJC’s virtual care program to grow and be paid fairly for the services provided.
Mandatory Nurse Staffing Ratios
A measure to set maximum patient-nurse staffing ratios at hospitals throughout Illinois failed to come to a vote during the spring legislative session, but a similar bill will likely be filed again next year. Supported by the Illinois Nurses Association and opposed by every Illinois hospital, mandatory nurse staffing ratios create a one-size-fits-all, mandated nurse staffing ratio, but there is no conclusive evidence it improves quality or outcomes for patients. It could drive up health care costs in Illinois by at least $2 billion a year for patients, families, and employers, and the added costs threaten already financially struggling hospitals.
- Hospital transformation
- Not-for-Profit status
- Nurse staffing
- Budget challenges
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Page updated 10/24/19