Inside these posts: HMOs

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Blue Cross, Advocate raise bar on accountability

The state’s largest health insurer and the area’s biggest medical-care provider have signed an agreement that holds doctors and hospitals more accountable for performance and quality service.

The three-year deal between Blue Cross and Blue Shield of Illinois and Advocate Health Care, which operates 10 hospitals in Illinois, calls for Advocate to limit rate increases it negotiates from the insurance company. In addition, Advocate doctors and hospitals are being asked to meet performance targets tied to improved quality, safety and efficiencies of the medical care provided to patients covered by Illinois Blue Cross HMO and preferred-provider organization products. Get the full story »

Lawmakers push for delay of Medicaid HMO plan

By Bruce Japsen Some influential state lawmakers are pushing for a delay in a pilot program that would place some elderly and disabled Medicaid patients into HMOs.

The Illinois Department of Healthcare and Family Services, which runs the state Medicaid program for the poor, has issued a request for proposals by managed-care plans to provide medical care services to 40,000 seniors and adults with disabilities in suburban Cook, DuPage, Kane, Kankakee and Will counties. The Medicaid patients have to enroll in one of two health plans.

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