Amid Medicaid expansion and a coming state capitated payment system, a Chicago non-profit health plan created by providers two decades ago is expanding its network and eying growth for the next decade.
Family Health Network, a not-for-profit managed care plan created by Chicago-area hospitals in 1995, has doubled its network over the past three years, now counting more than 4,000 primary care physicians, specialists and clinics and 37 hospitals, the latest among them Erie Family Health Center and University of Illinois- Chicago Hospital.
FHN calls itself the only not-for-profit managed care community network serving Chicago's Cook County, where some 1.5 million adults, seniors and children were covered through Medicaid prior to the federal expansion and another 340,000 are expected to join the program this year.
As Illinois prepares for a major Medicaid managed care rollout this July, partly as a way to address persistent budget woes, Family Health Network is positioning itself to compete with traditional MCOs and sees its provider roots as one major advantage.
"Medicaid recipients are increasingly being enrolled in managed care plans, and our long experience serving these populations has taught us that community-level outreach and education is the key to achieving positive health outcomes," said Keith Kudla, Family Health Network CEO, in a media release.
"As other Medicaid health plans have come and gone, we have grown and are well positioned to contribute to better health quality for Medicaid enrollees entering managed care plans," said Kudla, a former executive at WellCare and UnitedHealth's Illinois divisions.
Commensurate with the growth of its provider network, Family Health Network has seen membership double over the past three years, to more than 88,000. It's one of three MCOs in Cook County covering patients in the first, voluntary phase of the managed care rollout, along with WellCare's Harmony Health Plan and the physician-owned Meridian.
And, following that growth, Family Health Network is in the midst of a small hiring spree, looking for risk managers, social workers, business analysts, nurse practitioners and directors for finance, specialized primary care and pharmacy services.
By 2015, as part of a 2011 state law, half of all Illinoisans covered in Medicaid are required to be enrolled in managed care plans.
The accountable care entities, as the Illinois laws calls the managed care organizations, may end up serving as many as 1.75 million children, families and adults on Medicaid, and eventually, after three years in operation they're slated to move to a capitated payment system.