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Medicaid Reform Progress Report
The glitches in Florida’s Medicaid reform pilot program aren’t likely to derail an expansion across the state.
Sen. Rich says the Legislature needs to address the physician reimbursement level overall. “I would submit to you, (doctors) are not leaving because of Medicaid reform; they’re leaving because of reimbursement rates.”
Sen. Durell Peaden Jr., the bill’s original sponsor and chairman of the Senate Health and Human Services Appropriations Committee, agrees but is wary of cost. The Healthy Florida Alliance, a group focused on expanding health insurance coverage and reducing tobacco consumption, proposes increasing Florida’s tobacco tax by $1 per pack of cigarettes and using the money to increase reimbursement rates for physicians who provide Medicaid services and also expand healthcare for low-income children and adults.
SAVINGS?
Florida's Medicaid Population |
|
Age |
Population on Medicaid |
0-5 |
534,784 |
6-10 |
273,532 |
11-18 |
356,102 |
19-20 |
42,929 |
21-35 |
243,316 |
36-59 |
272,064 |
60-64 |
49,987 |
65-74 |
153,281 |
75-84 |
123,059 |
85+ |
62,110 |
Total |
2,111,164 |
Source: Florida Agency for Health Care Administration, data as of May 31, 2007 |
|
Arnold says it’s too early to tell whether the pilot programs are succeeding at the critical goal of cutting Medicaid costs for the state. In its waiver application, Florida agreed that the federal government wouldn’t have to increase its share of Florida’s annual Medicaid budget by more than 8% per person. The state pays the HMOs a risk-adjusted premium for each Medicaid enrollee based on the patient’s age, sex, geographic location and health status. The PSNs will be paid on a fee-for-service basis for three years and then a set premium per patient similar to an HMO. Says Arnold, “I’m absolutely convinced this will prove to be cost-effective.”
