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Florida to begin Medicaid overhaul demonstration

Physician Practice Advisor, October 26, 2005

Florida will overhaul its Medicaid program under a plan approved by the Department of Health and Human Services (HHS) on October 19.

Under the plan, a demonstration overhaul will occur in Broward and Duval counties, in July 2006. A statewide implementation plan will follow, according to an HHS press release. The demonstration will run through June 30, 2011.

The plan will

  • calculate an annual amount that it will provide for each enrollee, determined by reviewing the enrollee's health status and "historic use of healthcare services"
  • allow beneficiaries to choose a managed care plan with a benefit package that suits their needs
  • allow beneficiaries to voluntarily "opt-out" of Medicaid altogether and receive subsidies for their share of the cost to purchase employer-sponsored insurance.
  • establish an "enhanced benefit account" program to provide incentives to enrollees who participate in activities that promote healthy behaviors, such as weight management, smoking cessation, and diabetes management
  • create a $1 billion fund to pay providers caring for the uninsured

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