July 23, 2014

2007 Industry Outlook

Healthcare

Florida's experiment to allocate Medicaid dollars more efficiently will get plenty of scrutiny.

Barbara Miracle | 1/1/2007


Tackle the problem of Floridians under age 65 who do not have healthcare coverage.

Provide more funding to train more nurses and other hard-to-recruit medical personnel and designate the workers as "essential services personnel" so that they will qualify for affordable housing initiatives.

Allow for flexible and innovative benefits plans that would come with lower premiums and encourage a product designed for uninsured college students and young adults.

Continue to make healthcare costs "transparent" to consumers and the business community.

Re-enact no-fault auto insurance. The Florida Hospital Association argues that without a solution, hospitals will immediately experience an increase of more than $450 million in uncompensated claims related to uninsured motorists.

Critical Stage

As Gov. Jeb Bush leaves office this month, his initiative to reform Medicaid -- the state-federal program that provides health benefits to lower-income children, pregnant women, parents, people with disabilities, seniors and others -- is moving into high gear.

At Bush's request, the U.S. Department of Health and Human Services in 2005 granted Florida a five-year waiver -- the first in the nation -- that gives the state flexibility to structure Medicaid benefit packages that don't follow the federal government's defined-benefit model.

The Legislature authorized pilot programs in Broward and Duval counties for children, parents and people with physical disabilities who receive health benefits through Medicaid. Mandatory enrollment began in those counties in September.

The distinguishing feature of Florida's experiment is that the Medicaid recipients make choices about their coverage. Program designers say that allowing them to select a benefit package that's most appropriate for their health needs will allocate the Medicaid dollars more efficiently, providing better care while holding down costs.

The more than 125,000 participating Broward County residents can choose from among nine health maintenance organizations (HMOs) and four provider service networks (PSNs). In Duval, 80,000 Medicaid participants can choose from among three HMOs and two PSNs.

To help people decide on a plan, the state provides a call center with 45 counselors. Additional counselors -- 10 in Broward and six in Duval -- work in offices in those communities.

Tags: Healthcare

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