Florida approved for Medicaid privatization

The final approval for Medicaid privatization has been passed by Federal officials. Gov. Rick Scott announced the decision at the end of last week, indicating the new overhaul would “provide Medicaid users with quality, value-based and patient-centered care.”

SEE ALSO: Obama’s critic Rick Scott now backs Medicaid expansion in Florida

For years, Florida officials have expressed concern with that state’s annual Medicaid costs consumed too much of the budget, and the new program is designed to monitor Medicaid spending, while holding health care companies accountable for where they spend their money.

“Florida is leading the nation in improving cost, quality and access in the Medicaid program. CMS’s final approval of our Medicaid managed care waiver is a huge win for Florida families because it will improve the coordination of care throughout the Medicaid system. Healthcare providers can now more effectively manage chronic conditions and work with families to provide preventative treatments,” said Gov. Scott in an official statement.

Under the new program, which was just recently expanded to reach an additional 1 million Floridians, health care companies will have to spend a set amount of money directly on patient care, while having a working list of goals they must continually try to achieve.

Other highlights of the Medicaid privatization include:

• Increases recipient participation on Florida’s Medical Care Advisory Committee.
• Appoints smaller committees to oversee special interest groups.
• Replaces the Enhanced Benefits Accounts program with Healthy Behaviors programs to encourage and reward healthy behaviors.
• Medicaid plans must offer a medically approved smoking cessation program, a medically directed weight loss program and a substance abuse treatment plan.
• Florida’s External Quality Assurance Organization will review the quality of Medicaid programs every 3 years.
• Establishes health plan report cards for recipients for quality assurance.
• Establishes  plan performance improvement projects that focus on six key areas with the goal of achieving improved patient care.
• Focuses on a continual Medicaid quality strategy program to focus on all aspects of improving the care provided to Florida recipients.

“When I met with HHS Sec. Sebelius in DC, I underscored how important it was for Florida to have increased flexibility in our Medicaid program by granting us the ability to utilize private insurers and other innovative providers,” said Scott. “With this long awaited waiver, we will be able to provide Medicaid users with quality, value-based and patient centered care.”

While the program is said to now be free of issues, critics are still skeptical, indicating the pilot program had more than its fair share of issues, including complaints that providers were skimping on care and denying services in order to increase profits. Patients also complained about having difficulty getting appointments, and approximately 200,000 switched plans repeatedly.

SEE ALSO: Medicare and Medicaid Services: No more “Improvement Standard”

Only time will tell if the official program is up to par; the new overhaul includes more stringent penalties for doctors who might drop out of the plan, and new regulations also increase doctors’ reimbursement rates and limits malpractice lawsuits for Medicaid patients in hopes of increasing doctor participation in the program.