A Healthcare Win for Florida
Florida’s policymakers have accomplished an incredibly difficult balancing act in recent years. Massive healthcare policy changes have been passed down for implementation by the federal government while, at the same time, state-centric policies have been debated and shaped to reflect Florida’s unique population and health care matrix. In this confusing and sometimes contentious environment good news can often be elusive. However, recently officials were able to deliver fantastic news.
The Florida Agency for Health Care Administration (AHCA) announced that health plans participating in the Statewide Medicaid Managed Care (SMMC) program are steadily improving the quality of healthcare for thousands of Florida families. For 2014, the health plans met or exceeded the national Healthcare Effectiveness Data and Information Set (HEDIS) averages in 65 percent of all measured categories, and in the vital areas of prenatal care, diabetes management and breast cancer screenings the health plans are registering significant improvements.
Welcoming the report on performance metrics measured by the National Committee for Quality Assurance, AHCA Secretary Elizabeth Dudek said, “Medicaid recipients enrolled in Managed Medical Assistance plans now have access to the highest quality of care in the history of the Florida Medicaid program.”
In 2011, the Florida Legislature enacted and Governor Rick Scott signed legislation to make major changes to the fragmented fee-for-service system used to care for our Medicaid population. The bold shift to a managed care system was made in the belief that patient outcomes improve with a connection to a single, comprehensive, coordinated health delivery system.
The health plans chosen to carry out this experiment went to work and, fortunately, for Florida’s most vulnerable residents the change has netted fantastic results. And kudos to the health plans’ members who have embraced the changes to Florida Medicaid and are benefiting from greatly improved outcomes in the SMMC program in a short amount of time.
Florida’s chief economist, Amy Baker, recently highlighted a continuing challenge to all of our healthcare programs telling a legislative committee that healthcare costs will continue to climb. She added, however, that managed care would prevent these healthcare costs from growing at an even greater pace.
Florida policymakers continue their work on approaches to turn around healthcare inflation within the state, but national trends in this area threaten to overwhelm their efforts.
Ms. Baker has also said that higher budgetary needs in the SMMC program are being generated by a growing Medicaid population in addition to medical inflation and significant increases in pharmacy expenditures. However, the per-patient costs under SMMC have been reduced at the same time the quality of care has consistently improved. The fact is, improved health outcomes through a more efficient and effective delivery system, such as those demonstrated by the improved HEDIS scores, go a long way toward restraining costs.
So while we take a moment to celebrate these successes, the Florida Association of Health Plans recognizes there is so much more work to do. The improvements in quality reflected by the HEDIS scores need to be increased, and we must redouble our efforts to respect every taxpayer dollar. We will continue to stand with Governor Scott and the Florida Legislature as their difficult work to make Florida’s healthcare system even better continues.
For more on the Florida HEDIS scores click here or go to
Audrey Brown, President and CEO
Florida Association of Health Plans
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