Federal officials gave final approval last June to Florida’s Medicaid managed care program, which will move nearly 3 million recipients into private HMOs by the beginning of 2014. Florida’s legislature first passed the initiative in 2011, with proponents arguing that Medicaid’s normal fee-for-service system leads to inefficient resource allocation and inferior care.
During the two-year series of negotiations between Florida and Federal officials, the state also agreed to several regulations and consumer safeguards, including:
- A rapid-cycle response system for recipient complaints
- Increased recipient participation in Florida’s Medical Care Advisory Committee
- Continuation of current services for up to 60 days after enrollment
- HMO validation by Florida’s External Quality Assurance Organization
As in most states, Florida’s Medicaid costs are rising annually, and 2013-2014 expenditures are projected to rise above $22 billion. Privatization supporters expect the new program to curb future cost increases while improving the quality of care.
Beginning with Long-Term Care Florida’s transition to the program began with roughly 90,000 long-term care patients, many of whom have already enrolled in select insurance plans. Those who haven’t yet chosen will have until December 1st to select from one of seven available state-approved plans.
Under this new system, Medicaid funds will first be paid out to these select insurers, who will then use the money to pay nursing homes, in-home caretakers and other elder care providers. Long-term care patients are Medicaid’s costliest recipients, and Florida lawmakers hope this kick-off will quickly lead to considerable savings.
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Florida is the first state to adopt such a heavily privatized program, but it likely won’t be the last. Medicaid payments currently assist nearly 60 percent of all nursing home residents nationwide, and the retirement age population is growing larger by the day.