Higher Ed Group Weighs In On Health Alliance Snub
The head of one Illinois retirees group says there are many unanswered questions regarding the state’s recent decision to remove Health Alliance from its list of Medicare providers in 2014.
Linda Brookhart is the Executive Director of the State Universities Annuitants Association, which advocates for higher education employees and retirees.
She expects delays in setting up relationships with new doctors, since those currently on Health Alliance can’t use Carle Foundation Hospital, and may have to travel as far as Springfield for care. Retirees are now being asked to apply for Medicare Advantage plans with Aetna Life, Humana Health, Humana Benefit or United Healthcare.
And Brookhart said there’s no way of even knowing the level of care will be same.
“People do not feel that they have had enough time to make that decision, and since the plan itself is not but rolled out yet - they don’t know what the plan consists of," she said. "And if you talk comparable, what is comparable? What is the definition of comparable to what they have now?”
Brookhart said the 15,000 retirees who rely on Health Alliance can’t even find out yet what the benefits are with the four other carriers now offered to them.
“CMS (Illinois' Department of Central Management Services) says, 'please don’t call the carriers because their staff isn’t familiar enough with the plan yet," she said. "Well, the reason they’re not familiar enough with the plan yet because the plan isn’t really available for public consumption. Or probably, there’s going to be a certain amount of training for staff.”
In 2011, the state dropped Health Alliance contracts for retirees and current employees – prompting an uproar among legislators and court hearings that led to the decision being reversed. Brookhart questions whether the move is politically motivated, noting former Governor Rod Blagojevich tried to end Health Alliance contracts in 2004.
Brookhart said she’s heard no response from the state as to why it’s happening again for retirees – but is confident legislators will address the issue in the fall veto session late this month.
Urbana-based Health Alliance says it will file a protest with the state over its decision not to continue their HMO contract for state employees and retirees.
The state Department of Healthcare and Family Services announced Wednesday it was awarding HMO contracts for the next fiscal year to Blue Cross Blue Shield, with Open Access Plan contracts to PersonalCare and HealthLink. The state said the new contracts would save taxpayers over $100 million a year, and over one billion dollars over the next ten years.
Health Alliance CEO Jeff Ingrum argues the savings aren't really there --- in part because people who had been under Health Alliance will be required to either change doctors, or go to the more expensive Open Access Plans selected by the state, or to the Quality Care Preferred Provider plan, which offers less coverage.
"One, it will increase the costs to state workers," Ingram said. "But it will also increase the costs to the state of Illinois, because those programs are anywhere from 10 to 20 percent higher than the Health Alliance HMO program."
Ingrum says Carle, Springfield Clinic and McDonough District Hospital in Macomb had signed exclusive agreements with Health Alliance that barred them from working with other state HMO plans.
In a statement, Carle says it's studying the implications of the DHFS decision. The company calls on their patients who are Health Alliance members to "share their concerns with the state and with elected officials."
The company says it will be reviewing options "for state employees to continue accessing Carle physicians and hospital services", but that the plans and costs for such access will change if the state's decision stands.
And the state Department of Healthcare and Family Services says --- in a fact sheet on its managed care announcement --- that while Carle and other hospitals and clinics may not be available through their new HMO plans immediately, it expects them to "adjust to market needs" over time.
Carle says that Carle Foundation Hospital has a long-standing contract with Blue Cross/Blue Shield, for hospital services. But Health Alliance's Ingram says the contract is for a Preferred Provider plan, not the HMO plans which the state approved its employees and retirees in FY 2012.
State Representative Naomi Jakobsson (D-Urbana) has complained about the state's decision not to use Health Alliance next year. She says the company was not given sufficient advance notice of the decision. Jakobsson is inviting people concerned about the change to sign a petition on her legislative website.
NOTE: This story was updated to show additional comments from the Illinois Department of Healthcare and Family Services.