Georgetown University released a report today indicating that Florida’s Medicaid managed-care Reform Pilot program has not shown any clear signs of saving money. Nevertheless, the state Senate Health and Human Services committee will vote tomorrow on S.B. 1972, “which establishes the Medicaid managed care program as the statewide, integrated managed care program for medical assistance and long-term care services.”
This Medicaid managed-care program has been implemented in Broward county since 2006. Local critics recently told The Florida Independent this program decreased health cares costs because it decreased enrollment and coverage.
The Georgetown report (pdf.) states: “More than four years into Florida Medicaid’s managed care pilot program, the benefits of what is commonly called ‘Medicaid reform’ remain far from clear.”
It also adds that the initial 2006 waiver application to implement this Medicaid reform
was granted in record time by the [George W.] Bush administration. But investigations by the U.S. Government Accountability Office found that public participation in the development of the proposal was inadequate, and that the federal Secretary of Health and Human Services likely overstepped his authority in granting certain aspects of the waiver. For these reasons, and because significant federal funding is at stake, it is unlikely that the Obama administration would renew the waiver without some changes.
Georgetown data shows that the number of HMOs providing services and enrollment through the pilot program dropped from almost 80 percent of all people enrolled in 2008 to about 54 percent in 2011.
According to the report, in Broward County, “the withdrawal of Wellcare, Amerigroup, United Healthcare, Vista and Buena Vista means that plans representing two-thirds of the market share in 2008 are no longer participating in Broward today.”
This drop has brought a disruption in the quality and timeliness of health care provided to Broward patients and providers enrolled in the Medicaid managed-care model.
The report states: “Medicaid is a critical part of the health care system in Florida. It covers about 27 percent of the state’s children, pays for 51 percent of all deliveries and nearly two-thirds of nursing home days.”
It also points out that Medicaid costs “significantly less on a per-person basis than private insurance – often because provider reimbursement is low. This is especially true in Florida, which has a low per-person cost – ranking 43rd in the country.” The report adds that a majority of dollars that support Florida’s Medicaid program come from the federal government under a system of matching funds.
Georgetown concludes: “Much critical information is still lacking about the impact of Florida’s Medicaid pilots, including whether or not the pilots have saved money – and if they have whether the savings came at the expense of needed care.”