The federal Centers for Medicaid and Medicare Services has given full approval for Florida to essentially privatize its Medicaid program. Under the agreement, healthcare companies will have to spend a set amount of money directly on patient care.
The state began the managed care transition earlier in the year for people in long-term care. That will now extend to the state’s 3.3 million Medicaid recipients, who are mostly low-income pregnant women and children. Instead of the state paying claims directly to providers, it will give lump sums of money to health insurance companies, which will contract with doctors. Laura Goodhue, with the healthcare consumer group Florida Chain, says she’s cautiously optimistic about the program.
“However, we still have concerns, and our main concern is that our state agency for healthcare administration really listen to patients and providers and hold HMO’s accountable for what they are supposed to do," she said.
Supporters say managed care will lead to better health outcomes for patients and save money. But studies done on a smaller, five county pilot program in the state are inconclusive on that.
CMS had indicated the approval was coming earlier in the year when it granted an "Agreement in Principle" to the state when it approved the smaller, long-term care transition.
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