Florida's Medicaid Waiver Will Be Scrutinized Closely

John Marcille

Sometimes, following the changes in health care is like trying to take in several tennis matches at once. You might wind up knowing who won, but you'd be hard-pressed to say how it happened.

Employers want to shift more of the financial burden to employees — hence the growing interest in consumer-directed health care. But what's this? Seems that there's some shifting going on in the public sector as well.

Medicaid may meet managed care in a big way in Florida, thanks to the recent federal approval of a plan that Gov. Jeb Bush hopes will cut skyrocketing spending on the entitlement program.

On Oct. 19, as we were beginning to put the finishing touches on this issue, Health and Human Services Secretary Michael Leavitt approved a Medicaid waiver application that will shift 210,000 beneficiaries in Broward and Duval counties into managed care beginning in July 2006. That's pending approval by the state Legislature, which plans to hold a special session on the matter next month.

Entrusting these beneficiaries to managed care plans can potentially be good for them, while controlling costs. But it will be some time before we know whether they got the details right, particularly a provision that relates limits on a person's care to his historical usage. If it is intended to curb abuse, fine, but after all, health insurance guards against catastrophic costs. Medicaid may not be "insurance" per se, but it has much the same function and purpose.

What's going on in Florida isn't just an exercise in state budget management. It's also an opportunity for insurers to demonstrate their usefulness — again.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

Subscribe to Our Newsletters

Monthly table of contents

Be notified as each issue of Managed Care is available online.

Biweekly newsletter

Recent topics have included:

PTCommunity news

New drug approvals, clinical trials, drug management. Three times per week.


Managed Care
By Peter Wehrwein
Managed Care
By Howard Wolinsky