South Florida Business Journal Article About Medicaid Reform 11/21/05

Florida Medicaid reform to begin

South Florida Business Journal - October 21, 2005

With the federal government approving Florida's plan to begin privitizing its Medicaid program, Broward County is to be one of the first areas in the state to see changes.

The U.S. Department of Health and Human Services has said Florida Medicaid beneficiaries may choose managed care plans for their health care needs.

The program is designed to provide Medicaid beneficiaries who enroll in managed care plans access to better-quality health care services, while also allowing state officials to maintain a reasonable rate of program growth, HHS said.

Florida, HHS added, requested the program after determining its Medicaid growth rate -- 13 percent a year for the last six years --- was unsustainable. This year, Medicaid spending is projected to take up 25 percent of the state's budget, or more than $15 billion.

The demonstration program is to begin in two counties, Broward and Duval, in July 2006. Statewide implementation is to follow. The demonstration is to run through June 30, 2011.

Medicaid beneficiaries in the program are to select from a group of state-approved managed care plans that will compete for their business.

In addition to having a choice of managed care plans, beneficiaries may also choose to opt out of Medicaid altogether. Under this scenario, a person or family would receive subsidies for their share of the cost to purchase employer-sponsored insurance.

The demonstration is also to establish an "enhanced benefit account" program. This would provide incentives to enrollees who take part in activities that promote healthy behavior, such as weight management, smoking cessation and diabetes management.

A $1 billion-a-year fund is to to help the state pay safety-net providers caring for the uninsured.