Fla. pilot program to cut Medicaid costs raises new questions

Source: The Washington Post

FORT LAUDERDALE, FLA. — To visit the low-rise medical offices dotting the sun-bleached highways of Broward County is to meet doctors and patients who complain of being guinea pigs in a social experiment gone wrong.

They are part of a five-year pilot program designed to test whether Florida can reduce spending on Medicaid, the public insurance program for the poor and disabled, by largely turning the program over to for-profit HMOs. Success would mean getting a handle on one of the fastest-growing and most vexing expenditures confronting states.

But it’s unclear whether the pilot, which is also underway in four other counties, has achieved that. Health professionals here say any savings have come at a high cost: the quality of care. And they are outraged over the legislature’s decision last week to essentially expand the pilot statewide, which will be carefully watched by other financially strapped states across the nation.

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The pending law, which requires the approval of the Obama administration, largely drops the traditional fee-for-service model under which a state reimburses doctors and pharmacies for every procedure or drug provided to a Medicaid patient. Instead, virtually all patients would be required to sign up for a private HMO or similarly run provider-service network set up by hospitals and doctors. These managed-care organizations would be paid a set amount for each patient’s care, taking the hit for any overruns but keeping most of any savings.

Read more: http://www.washingtonpost.com/national/florida_adopts_new_medicaid_plan_to_cut_costs/2011/05/06/AFTByItG_singlePage.html