Far from being overtaken by a provider-led managed care movement, Molina is getting into the game.
Molina Healthcare is acquiring MyCare Chicago, one of 11 accountable care entities created in Illinois as part of a Medicaid overhaul program.
MyCare Chicago, launched last year, is owned and operated by several local Chicago hospitals and family health centers, including Mercy Hospital and Medical Center, Norwegian American Hospital and Swedish Covenant Hospital. The organization coordinates healthcare for about 61,000 Medicaid beneficiaries in Chicago's Cook County, through a contract with the Illinois Department of Healthcare and Family Services.
Under the deal with Molina, MyCare Chicago will continue to operate its provider network and coordinate care for enrollees. Financial terms of the deal were not disclosed.
"This move is an exciting step in coordinating care to help those in need at sustainable costs," said Felicia Norwood, director of the Department of Healthcare and Family Services, which created and funded MyCare Chicago and the other accountable care entities. "We believe that provider sponsored and managed care organizations can thrive and offer superior care for our clients."
Mark Newton, chair of the MyCare Chicago board and president of Swedish Covenant Hospital, said the founders of MyCare Chicago are hopeful the acquisition will help the organization's mission evolve further.
"The founders are proud to be co-creators of a cutting edge model to build and strengthen provider-driven care that manages and assures access for Chicago's most vulnerable," Newton said. "The agreement between MyCare Chicago and Molina Healthcare of Illinois provides the resources needed to invest in advanced information systems and patient centered care coordination systems that improve population health status and lower costs."
Molina Healthcare currently covers about 102,000 Illinoisans in Medicaid and Medicare plans, including dually eligible individuals.
In Illinois, the stakes are particularly high for the future of Medicaid, and managed care companies like Molina are looking to be a part of it. Some 3.16 million Illinoisans are now covered by Medicaid and CHIP, up 20 percent from 2013, creating worries for the state budget and putting pressure on those participating in the accountable care program.
In 2020, when states have to pay 10 percent of costs for the newly-eligible Medicaid patients, the costs for Illinois as a whole will be an extra $200 million, on top of the more $8 billion the state currently spends. In Cook County, the newly-eligible will bring $72 million in costs.
But, if the population is adequately treated, overall spending may be more sustainable, according to Jay Shannon, MD, CEO of the Cook County Health and Hospitals System, which is also running its own accountable care entity.
"For the first time in this organization's history, we have a majority-insured population," Shannon told the Associated Press, noting that the county's uncompensated care costs fell from more than $500 million in 2013 to $342 million in 2014. "That's entirely because of the Medicaid expansion."