December 4, 2022

Healthcare

Medicaid Reform Progress Report

The glitches in Florida’s Medicaid reform pilot program aren’t likely to derail an expansion across the state.

Barbara Miracle | 9/1/2007

HOPEFUL SIGNS AND QUESTION MARKS

One part of the pilot allows participants to opt out of Medicaid and apply their Medicaid premiums toward purchasing a private health plan. The idea is that Medicaid recipients who work for companies that offer health insurance can use their Medicaid allotments to purchase a plan that’s better or includes more family members. As of the end of August, however, only nine people had enrolled in the program. It appears that most who are eligible for Medicaid don’t work for companies that offer healthcare, says Paul Duncan, the University of Florida professor who is leading the state-funded evaluation of Medicaid Reform.

Another part of the pilot is an “enhanced benefits” program for Medicaid participants who take steps toward a healthier lifestyle. Getting routine mammograms, stopping smoking or participating in disease management programs for chronic illnesses, for example, earns participants up to $125 per year with which they can purchase things like non-prescription pain medication, bandages, heating pads and other over-the-counter medical products.

Participants have responded, accumulating a total of $4.3 million in their accounts as of June. But they had spent only $131,493. It’s unclear whether people are saving up their credits, don’t understand the plan or are having difficulty using the credits at pharmacies. The state has put together a laminated information sheet to help participants and pharmacies better understand the program.

To help beneficiaries decide on a plan, the state operates a call center with more than 30 “choice counselors” and has stationed 10 counselors in Broward County and six in Duval, Baker, Clay and Nassau counties. Because of the counseling, more than two-thirds of enrollees selected a managed care plan and did not have to be randomly assigned to a plan, says Arnold.

Medicaid Reform
Enrollment in the five biggest plans (as of June)
Broward County
Provider
Plan
Members
% of Medicaid Enrollees
Staywell (WellCare)
HMO
25.651
24.4%
HealthEast (WellCare)
HMO
14,087
13.4
Amerigroup
HMO
10,189
9.7
Humana
HMO
9,928
9.4
Pediatric Associates
PSN (Provider Service Network)
9,721
9.3
Duval County
HealthEast (WellCare)
HMO
35,995
52.1%
First Coast Advantage (Shands/Jax)
PSN
14,953
21.6
United Healthcare
HMO
7,532
10.9
Access Health Solutions
PSN
6,725
9.7
Staywell (WellCare)
HMO
2,469
3.6
Source: Florida Agency for Health Care Administration

Tags: North Central, Healthcare

Florida Business News

Florida News Releases

Florida Trend Video Pick

Check out this Miami Beach art exhibit made by chimpanzees
Check out this Miami Beach art exhibit made by chimpanzees


Take a look at the ‘@rt by Chimps’ exhibit at the New World Symphony Center in Miami Beach. Chimpanzee artists painted 15 canvases that were up for sale during the fundraising event and all proceeds from sales go toward the Save The Chimps sanctuary.

Video Picks | Viewpoints@FloridaTrend

Ballot Box

Is it your opinion that the coronavirus pandemic has ended in the United States?

  • Yes
  • No
  • Unsure
  • Need more information
  • Other (Please share your comments in the comment section below)

See Results

Florida Trend Media Company
490 1st Ave S
St Petersburg, FL 33701
727.821.5800

© Copyright 2022 Trend Magazines Inc. All rights reserved.