Florida has received federal approval to move approximately 2.9 million Medicaid recipients into managed-care programs as soon as next Jan. 1, Gov. Rick Scott's office announced today.
It's a major victory for Scott and the Florida Legislature -- which passed managed-care legislation in 2011 and has been awaiting federal approval ever since -- who argued that changing from the current fee-for-service Medicaid system would provide better, more comprehensive health care at a lower cost. It's also a win for the state's private health insurers, who'll be able to compete for a huge new market. The program envisions that patients will be enrolled in HMO-like plans set up either by private insurers or by groups of hospitals and doctors.
The approval, by the federal Center for Medicare and Medicaid Services, came after the state agreed to a set of consumer-friendly regulatory changes, including a "rapid cycle" response to consumer complaints and a requirement that companies and networks spend at least 85 percent of their premium income on medical care -- a provision that at one point was voted down by lawmakers.
Five-year-old trial managed-care programs in Broward County and north Florida produced mixed results, according to studies, and it's not clear if they saved money. Some patients complained about access to care, especially after some of the initial participating providers dropped out of the program. The changes mandated by CMS were intended, among other things, to ensure patient access to care.
“Florida is leading the nation in improving cost, quality and access in the Medicaid program. CMS’s final approval of our Medicaid managed care waiver is a huge win for Florida families because it will improve the coordination of care throughout the Medicaid system," said Scott in a statement.
"Healthcare providers can now more effectively manage chronic conditions and work with families to provide preventative treatments. When I met with HHS Sec. Sebelius in DC, I underscored how important it was for Florida to have increased flexibility in our Medicaid program by granting us the ability to utilize private insurers and other innovative providers. With this long awaited waiver, we will be able to provide Medicaid users with quality, value-based and patient centered care.”