Florida’s elderly, disabled, and low income adults will be pushed into the new era of healthcare that will become available over the next five months. This era will change the way that they are able to receive their long term care from Medicaid, which is the federal state program for the disabled and poor. 90,000 residents will have their living assistance services managed by a private insurance company as Florida health officials start providing a Medicaid reform. The reform began on Thursday in the Orlando area with almost 9300 eligible Medicaid recipients becoming the first people enrolled in the long term managed care program.
Many individuals will be choosing a health plan for the first time based on the new reform. It aims to move all of Florida’s 3 million Medicaid recipients to privately managed health plans in order to help lower costs while still improving or maintaining the quality of care in the long run. During 2011-2012, Florida’s Medicaid recipients cost around $20.3 billion. The federal government paid around 56 percent of that and the state covered 44 percent of those costs. Medicaid recipients in long term managed care, including those who would be in nursing homes and assisted living care homes, are some of the most expensive beneficiaries to care for. They cost around $3.5 billion every year.
During 2011, the Florida legislature made managed care mandatory for everyone who was in Medicaid. Florida health officials are launching the reform with the long term care percentage of the population. Most of these people are seniors and receive daily living assistance based on their condition. Disabled adults are also able to participate in the program. During fall of 2014, the state officials will begin a second phase of transition by moving the remaining percentage of the Medicaid portion into the managed care plans. Based on managed care, private health plans will be able to receive a fixed amount of money per patient per month in order to help manage a patient’s care. This means that previously approved services may need to be re-assessed and may even be denied as medically unnecessary.
In consideration of these new plans, Medicaid recipients are receiving promises of more coordinated care, while the state is hoping to lower its costs overall. Insurance companies are gaining a lot of potential profits for agreeing to be able to manage the services. However, there are some risks that eligible Medicaid recipients will not be able to receive the counseling or appropriate care to help them choose a plan or that managed care companies will be more motivated to deny needed care so that they can make a profit. Ultimately, it is going to be a change that will involve some trial and error before it will be an ideal option for all included, but for now, there are many seniors and disabled adults who feel that the program will be promising and will provide them with an alternative to having coverage for their care.