CHICAGO (AP) — A for-profit nursing home company owned by a politically connected Chicago businessman is a partner in a project Illinois Gov. Pat Quinn announced Tuesday that aims to control health spending for high-cost Medicaid recipients.
The selection of MADO Management raised questions from one advocate for nursing home residents, who pointed to some MADO facilities' below-average staffing levels and violations found by regulators during inspections. But a state official said it's important for a nursing home operator to be involved as the state moves more mentally ill residents into group homes and independent living apartments, and MADO, owned by businessman Peter O'Brien, is the only one that applied.
O'Brien has been appointed to a state board and his late brother, Daniel O'Brien Jr., was a state senator and representative. But O'Brien's political connections didn't affect the selection, said Mark Mroz of MADO's health care unit. The 600-page proposal met every specification and came from "a large collaboration that stood the same chance as anyone else did in receiving this opportunity."
On his political involvement, O'Brien said he's never shied away from taking an active stance "when I thought that I could make a difference where I live and work" and he said MADO Healthcare "consistently meets industry standards" caring for people with mental illness. O'Brien added that his late son, also named Peter, was diagnosed with a serious mental illness when he was a college freshman.
"It was his journey that brought me to the realization of the need for a system for coordinated care for persons with serious mental illness — a person-centered program that follows those that suffer with this illness through their needs of hospitalization, rehabilitation and community care," O'Brien said.
In a news release, Quinn announced six "coordinated care" partnerships that will help Illinois comply with a state law requiring that at least half of Illinois Medicaid recipients be moved into managed care by 2015.
Instead of turning most of Medicaid over to national for-profit managed care companies, state officials are opening some contracts to Illinois health care providers such as hospitals and mental health centers. The hope is they could work together to lower costs and eliminate unnecessary care — including some emergency room visits — while still serving patients' needs. It's those collaborative projects that were announced Tuesday.
Contracts haven't yet been negotiated. But most of the projects will receive fees for coordinating patient care, share savings with the state and be subject to financial penalties if they don't meet certain quality standards.
Most of the six projects are run by nonprofits such as hospitals and government health agencies. A nonprofit on Chicago's South Side called the Healthcare Consortium of Illinois will lead one network, for example. A group of hospitals and mental health centers will focus on nine counties in northwest and central Illinois. The Macon County Mental Health Board in Decatur will lead another partnership. Heartland Health Outreach in Cook County and the Community Care Alliance of Illinois, both nonprofits, were also named.
Overall, the six projects will coordinate care for up to 6,000 Medicaid recipients. The project is aimed at the costliest patients for Medicaid — the elderly and disabled.
