Improving Systems
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Saving Money, Saving Lives: Maryland Paves the Way on Payment Reform
As policymakers across the country look to balance their budgets, some are turning to Medicaid, recycling the same harmful policies they’ve used year-after-year: eliminating coverage for vulnerable Americans, restricting critical benefits like prescription drug coverage, imposing premiums on those who can’t afford them, and slashing already-low provider reimbursement rates. Community Catalyst and Georgetown University Health…
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CMS Asks Florida ‘Where’s the Beef’? (Do States Need a Waiver to do Managed Care?)
Last week the Centers for Medicare and Medicaid Services sent a letter to the Florida Agency for Health Care Administration in response to the state’s request for waiver authority to expand managed care statewide. CMS responded by saying that their Medicaid waiver extension request cannot be granted because it lacks a specific plan. The state’s…
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As Legislators Wrestle to Define Next Generation of Florida Medicaid, Benefits of Reform Effort Are Far From Clear
Medicaid is a critical part of Florida’s health care system. It covers about 27% of the state’s children, pays for 51% of all deliveries and nearly 66% of nursing home days. In 2006, a five-year pilot program replaced traditional Medicaid with an unusual managed-care model and other features that required a Section 1115 waiver from…
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Florida’s Proposed Medicaid Long-Term Care Changes Raise Host of Questions About Impact
Florida’s 2011 Managed Care Legislation, HB 7107, established “Medicaid Managed Care,” a new statewide managed care program for all covered services. Two separate components are anticipated for the new program: the Florida Long-Term Care Managed Care program, slated for implementation first, and the Florida Managed Medical Assistance program, an expansion of the Medicaid pilot program…
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Medicaid Managed Care – States Should Look Before They Leap (Again!)
By Joel Ferber, Legal Services of Eastern Missouri and nationally recognized expert on Medicaid A recent article in USA Today focused on Medicaid managed care and its implications for health reform. Health insurance companies are clamoring for the substantial new business that will become available when Medicaid coverage is expanded to an estimated 16 million…
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A Strong and Affordable Exchange Should be Children’s Priority
(Editor’s Note: John Bouman is the President of the Shriver Center. He is recognized for being one of the most effective and thoughtful public-benefit advocates in the country. Say Ahhh! asked him for his thoughts on national health reform.) We all worry about our children so of course we are concerned about the treatment of…
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Pediatric Medical Homes Improve Health and Lower Costs
Health reform is capturing all the headlines these days. And much of the emphasis is on how to contain costs. Unfortunately, what Americans aren’t hearing in the debate is a discussion about the proven ways to reduce costs while improving quality of care and health outcomes. The regrettable assumption is that containing costs means taking…
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Florida’s Experience with Medicaid Reform: What has been Learned in the First Two Years?
Two years after the launch of Florida’s Medicaid reform pilot it appears that beneficiaries’ access to heath care has worsened and financial benefits for the State of Florida remain unknown. Beneficiaries and providers think the Medicaid program has become more complex with more paperwork as a result of reform, and there are signs that access…
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The Enhanced Benefits Rewards Program in Florida: Is it Changing the Way Medicaid Beneficiaries Approach Their Health?
A key feature of Florida’s Medicaid Reform pilot is the Enhanced Benefits Rewards Program which provides each Medicaid beneficiary up to $125 a year in credits for certain healthy behaviors, such as keeping a doctor’s appointment. The credits may be applied to the purchase of health and personal care products at participating pharmacies. This policy…
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Florida’s Medicaid Reform Pilot Programs: Challenges with Mental Health Services
People with disabilities and chronic conditions, including persons with mental illnesses, present challenges for managed care organizations. As the Florida Legislature, other policymakers and the public track the Medicaid reform pilot programs, it is important to assess how this unique managed care model works for some of the diverse populations affected by reform. This policy…
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Uncertain Access to Needed Drugs: Florida’s Medicaid Reform Creates Challenges for Patients
This issue brief examines the prescription drug benefit available for Medicaid beneficiaries in Broward and Duval counties, the two pilot counties for Florida’s Medicaid reform program that began enrollment in September 2006. The research shows that half of the HMOs participating in the pilot are using the increased flexibility to limit their drug benefit. It…
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Waving Cautionary Flags: Initial Reactions from Doctors and Patients to Florida’s Medicaid Changes
This issue brief explores the initial reactions and experiences of Medicaid beneficiaries and doctors participating in Florida’s Medicaid reform program that began enrollment in two pilot counties in September 2006. It reports that provider participation is declining and that the reform program has made Medicaid more complex. It also highlights that children are the largest…
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Evaluating Florida’s Medicaid Pilots: Early Reactions from Doctors and Patients
Author: Joan Alker Assessing Florida’s Medicaid Reform Project — Presentation Document May 2007
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Florida’s Medicaid Reform
Authors: Joan Alker and Jack Hoadley Duval County Medical Society Forum — Presentation Document February 2007
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Medicaid Changes: What Will They Mean for Broward and Duval Counties, and Beyond?
In December 2005, Governor Bush signed into law a bill authorizing implementation of the state’s major Medicaid redesign in two pilot counties, Broward and Duval. This issue brief provides details of Florida’s program, the changes that will occur, and the proposed evaluation of the pilot. This issue brief was released as part of the Assessing…