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
Dr. Arthur Palamara, a Hollywood vascular surgeon and former vice president of the Florida Medical Association, says physicians are unhappy. “Doctors proportionate to their experience are way undercompensated. They’re all complaining,” he says, adding, “You’ve gone from an indemnity system to an HMO system. There’s absolutely no incentive for them to join these plans.”

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.”

Tags: North Central, Healthcare

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Check out this Miami Beach art exhibit made by chimpanzees
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