'Hospital transformation' plan will put money into critical access hospitals
On one of the last days of the lame duck session, lawmakers passed a sweeping piece of bipartisan legislation that revamps how hospital services are delivered throughout Illinois.
The "Hospital Transformation" bill passed unanimously out of both chambers and will soon head to Gov. J.B. Pritzker for his signature.
The bill makes about $150 million a year available to local communities to form partnerships that will improve medical access, with a focus on the uninsured and Medicaid users.
The program specifically targets "critical access" hospitals - like Marshall Browning in Du Quoin and Pinckneyville Community Hospital - which offer acute care and emergency medical services. It also targets "safety net hospitals," which serve large numbers of Medicaid and uninsured patients.
The funds are meant to encourage "integrated" health care, such as community-based services, preventive care, obstetric care, chronic disease management and specialists.
Funding for the grants will come from a statewide hospital assessment to earn federal dollars, which lawmakers renewed during the abbreviated regular session in May, combined with federal matching funds for Medicaid.
The bill was the result of a yearslong effort by a group called the Medicaid Working Group, made up of lawmakers from both parties and both chambers as well as officials from the governor's office and the Department of Healthcare and Family Services. The group consults with hospitals, clinics and other stakeholders to design Medicaid policy.
Greg Harris, D-Chicago, said that for several years the group has been focused on designing a modern Medicaid system that reflects a very different health care environment than the one that existed decades ago.
"When our system was designed, most health care was delivered in hospital settings, in medical surgery settings," he said. "Now, huge amounts of that kind of work is being done in outpatient settings, whether it's diagnostic imaging or specialty care, or same day surgery. Hospitals are not the central hub for a lot of services like they used to be."
Not all rural hospitals have access to the full array of medical services.
"In rural communities in central and southern Illinois, how do you make sure that quality health care is accessible in all those areas?" Harris said.
The bill calls on local communities to do community needs assessments to identify the particular needs of each community, and then form collaborations with hospitals, primary care, preventive care and specialty care providers, mental health and substance abuse providers and other local organizations to address them.
It also calls on them to submit proposals specifically designed to improve health care outcomes and reduce health care disparities, including specific metrics that can be used to track whether or not the project is meeting its goals.
Beyond that, the bill puts few limitations on the types of proposals that will be considered. Evan Fazio, a spokesman for the Department of Healthcare and Family Services, which will administer the grant program, said that was intentional.
"We want to cast a really wide net and we want this to be about what the community needs and what the community wants," he said. "And since it is a community-first initiative, we want people to kind of come up with the partnerships and collaborations that they think could come together to meet the needs of their community."
State Rep. Tom Demmer, R-Dixon, said the hospital transformation fund puts additional money in communities that are struggling with health care.
"The need has always been there," he said, "but it's been highlighted by the impact we've seen with COVID in a lot of communities."