Chicago | Illinois | 2023 | Market Overview Brief

Chicago providers and payers now have more transparent patient data sharing protocols, which should improve success with a growing number of risk-based arrangements. While incentive payments still are more common than risk-sharing, risk is the goal for most insurers, led by Blue Cross and Blue Shield of Illinois. COVID-19’s care coordination pressures, combined with technology advancements, finally spurred the market to coalesce around general patient data protocols and population health goals that could define the form of contracts going forward. The Illinois Blue plan now offers a two-sided patient data sharing system to some providers, with plans to add more in the future. Plus, the market’s largest integrated delivery networks are part of a new, national company that will share de-identified patient data to produce better evidence-based guidelines. The need to improve coordinated care and vaccine distribution for COVID-19 only intensifies the momentum behind data sharing and population health. While integrated delivery networks still court higher-paying commercial patients, there are efforts to address healthcare disparities on Chicago’s South and West Sides that include state funds for safety-net hospitals and coalitions of providers, payers, and community groups. Just as IDNs work to share some information, the competition for commercial patients heats up with IDNs building outpatient centers in the suburbs to attract oncology, cardiology, orthopedic, and women’s health patients. Payers retain an edge in contract negotiations in Chicago’s largely unconsolidated provider market, but as smaller hospitals are acquired by mid-size IDNs, providers gain clout as well. Expect risk-sharing to grow in the coming year, possibly with more capitated HMO contracts, with opportunities for outcomes-based drug contracts increasing as well.

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