Medicaid Transformation Watched Closely In Florida

Medicaid Transformation Watched Closely In Florida

This week the federal government signed off on the first part of a plan that could eventually steer more than 3 million low-income Floridians on Medicaid into a managed care, or HMO system. The decision comes two years after Florida lawmakers approved the conversion in an attempt to control costs in the $21 billion program.

At that time, retirees were skeptical of how it would work.

“For-profit companies have a fiduciary responsibility to do what? Make money. So they’re not going to manage their care, they’re going to ration their care,” said Joseph Flynn, a retiree living in the Central Florida community of the Villages, where Gov. Rick Scott was holding a budget signing ceremony.

That skepticism has not gone away but now the federal Centers for Medicaid & Medicare Services has signed off on part of a waiver allowing Florida to begin its transition to managed care for Medicaid recipients in long-term care.

Under the state’s current fee-for-service model, when the patient goes to a nursing home, hospital or doctor, the health provider bills the state, and the state cuts a check. But that system is expensive, difficult for frail patients to navigate and doesn’t necessarily result in good care. Florida officials and industry representatives say managed care will be an improvement.

Read more at http://www.kaiserhealthnews.org/Stories/2013/February/08/florida-medicaid-managed-care-long-term-care.aspx