A new report from the Florida Center for Fiscal and Economic Policy finds that access to medical care remains a problem for Floridians enrolled in the state’s five-county Medicaid Reform Pilot.

Many groups have spoken out against the state’s plans to move Medicaid beneficiaries into private managed care plans since the Pilot program was first created. The state is currently awaiting federal approval of a plan to expand aspects of the program statewide.

But the Center for Fiscal and Economic Policy study reports that access to care remains a persistent problem in the Pilot.

According to the study (.pdf):

In short, the primary care utilization statistics derived for this report corroborate the mounting anecdotal reports of problems with access in Reform. Specifically, during the 36-month period studied (January 2008 through December 2010):

    • The extent to which Medicaid recipients had access to primary care varied significantly among plans.
    • Overall, access to primary care in the Pilot counties was significantly and consistently worse than prior to the launch of Reform, and in the case of some plans, it was alarmingly worse. In particular, primary care utilization rates for a number of HMOs were deficient under any objective standard.
    • Plans’ business-driven maneuvers within the Reform experiment wreaked havoc on recipients’ access to primary care.
    • Provider service networks (PSNs) generally provided better access to care than their HMO counterparts.
    • Primary care access in Reform improved over time, but remained disturbingly low.

One of the chief complaints about the state’s Medicaid Reform Pilot, which went live in five Florida counties in 2006, was that pregnant women struggled to find proper access to prenatal care. There were rampant reports of pregnant women receiving delayed care, or even being removed from their plans. Patient advocates have written to the federal government, urging it to take the issue into account as it considers the state’s plan to expand the Pilot statewide.

Authors of the new study conclude that, “given the vulnerability of Medicaid recipients, these findings warrant suspension of efforts to expand and extend Florida’s particular Medicaid managed care experiment pending further analysis.”

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