From WILL - News Headlines -

Blue Cross HMO Plans for State Workers Would Cover Only 27 Counties

The HMO plans that the Quinn administration wants to offer to state employees starting in July only covers 27 Illinois counties.

Blue Cross/Blue Shield of Illinois' two HMO plans would serve the state's most populous counties, covering Chicago, Rockford, Springfield, Peoria and the Metro East. But the health plans have no health care providers signed up in most of east-central, southeast, southern and western Illinois would not be included.

Blue Cross spokesperson Mary Ann Schultz says in a press release that they're working to sign up more providers in other counties. In the meantime, she says state employees could use the other available plans. Those are the Quality Care preferred provider plan, which offers access, but a lower level of coverage; and two open access plans from HealthLink and PersonalCare. They offer HMO-level prices for physicians in their lowest tier, and higher prices if you want access to other doctors.

The state Department of Healthcare and Family Services says the new plans will save the state over $100 million a year. But State Representative Chapin Rose says the state's research erroneously projects Blue Cross' lower operating costs in urban areas onto the state of Illinois as a whole.

Rose's Illinois House district stretches from Charleston to Champaign, one of the areas not covered by the Blue Cross HMO plans. The Mahomet Republican says the alternatives have their flaws, too. He predicts how those in his region would use the new health plans.

"You have a bunch of people that either migrate on to (the) QualityCare plan, which will be incredibly expensive to the state taxpayers," Rose said. "Or they will dump into PersonalCare, and go to Christie Clinic. The problem is, Christie Clinic does not have the capacity to suddenly have 55-thousand people at its doors. Just can't do it."

Rose says many of those seeking care from Champaign-based Christie Clinic will be former patients of Urbana-based Carle. Health Alliance, which has an exclusive HMO arrangement with Carle, was turned down in the bidding for the new health plans. The open access plans would offer Carle at its more expensive tiers, and Christie Clinic at the lower-priced tier.

Health Alliance is filing a formal protest against the new health plans, and Rep. Rose says that should make documentation available that he believes will show the flaws in the health plan selection process. In the meantime, a legislative commission will review the plans on Monday, April 11th. The meeting of the Illinois Commission on Government Forecasting and Accountability is set for 10 AM at the Illinois State Capitol Building in Springfield. Rose says he's worried that the commission will vote to approve the plans before those documents are available.

The lawmaker says the best course of action would be for the commission to take its time on the matter. But he argues that an even better course would be for the Quinn administration to withdraw the health plans, and start over.

Categories: Government, Health, Politics