Contributed by Carla Sharetto| 12 January, 2005 20:03 GMT
Florida Governor Jeb Bush proposed a Medicaid reform initiative today, saying it would empower patients to direct their own health care and bring predictability to state spending on the $14 billion program. The governor is aiming for no less than a complete overhaul of the existing system.Medicaid is a state-federal partnership charged with providing health care to more than 2.1 million Floridians, including many elderly and disabled. The program has not been the targent of any significant reform since its inception more than 30 years ago, according to a statement on the governor's official Web site.
Market Competition to Drive Access, Quality
"To fulfill our commitment to Florida's Medicaid program, we must transform it completely so that the number one priority is patient wellbeing and the last consideration is government control," said Governor Bush. "Our proposals put the focus back on the patient by encouraging strong patient-doctor relationships and allowing competition in the market to drive access and quality of care up from current levels in the Medicaid system."
The multi-faceted growth of Medicaid has produced a complex maze of multiple, even conflicting components, the governor's statement says. Medicaid in Florida has continued to grow unchecked. If Florida's Medicaid program continues to grow at its present rate, it will consume nearly 60 percent of the state's budget by 2015. While state tax revenue has grown by 24 percent between 1998 and 2004, Florida's share of Medicaid has grown by 88 percent in the same period. At a total cost of $14 billion this year, combined federal and state spending on Medicaid has grown by 112 percent since 1999.
Collapse Under Its Own Weight
"Florida's Medicaid system will collapse under its own weight if we do not fundamentally transform the way it operates," said Governor Bush. "The changes we're proposing will help create more predictable and sustainable growth in Medicaid costs and ensure the program meets the needs of Floridians who rely on it for health care."
The major components of Governor Bush's Medicaid transformation initiative announced today include the following, as stated on the governor's Web site:
Defining a Patient-Centered Vision
The transformation begins by empowering Medicaid participants to make choices about their own care. Health care providers will create benefit packages falling into a combination of three components: basic care, catastrophic care and flexible spending. Participants -- with the help of choice counselors -- will choose the plan that best meets their needs.
Medicaid participants will be able to build a "bridge to independence" by "opting out" of Medicaid plans and using their state-paid premium to purchase insurance in the private market.
Participants will also be able to participate in a new feature of the benefit structure that encourages healthy practices and responsible lifestyle choices by giving Floridians the ability to earn enhanced benefits through flexible spending accounts. These enhanced benefits will give participants extra funds to buy increased coverage or services through their care plan.
'Medicaid Marketplace'
Governor Bush's reform proposal aims to give providers greatly improved flexibility in designing service plans. The plan envisions that providers will be free to compete for the membership of participants by offering innovative care, convenient networks, and optional services. Participants won't be limited to HMOs and insurance plans under the new proposal. Options like Provider Service Networks and innovative community-based systems will be available to meet the unique medical needs of participants.
Participants in the basic or catastrophic plan will have access to all types of mandatory health services, such as professional care, hospitalizations and diagnostic services, under the proposed reform.
Instead of the state setting the amount or scope of services, the competing vendors will be allowed to offer different packages that may appeal to different consumers when the governor's proposal takes effect. The state will continue to allocate the premium to each of the three categories based on historic spending patterns.
"Florida can't afford to wait any longer for real Medicaid reform legislation," said Agency for Health Care Administration Secretary Alan Levine. "This proposal is the starting point for a Medicaid program that Florida can live with well into the future." |
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