January 11, 2005

GOVERNOR BUSH ANNOUNCES PLAN TO TRANSFORM MEDICAID ~ Proposals to put
patients first

Tallahassee, Fla. - Governor Bush today unveiled his plan to ensure Florida's most vulnerable families continue to receive the quality health care they need, recommending reforms that will empower Medicaid patients to direct their own health care as never before. The reforms will also bring predictability to state spending on Florida's $14 billion Medicaid program. Medicaid, the state-federal partnership charged with providing health care to more than 2.1 million vulnerable, disabled and elderly Floridians, has not undergone significant reform since its inception more than 30 years ago.

"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. 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.

"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."

Governor Bush today announced the major components of his Medicaid
transformation initiative, empowering participants and putting patients
first, which includes the following:

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.

Creating a Medicaid Marketplace:

Governor Bush's reform proposal will give providers greatly improved flexibility in designing service plans. In addition to basic, catastrophic and flexible spending services, 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. Options like Provider Service Networks and innovative community-based systems will also 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 among others. 

• 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. 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. This proposal is the starting point for a Medicaid program that Florida can live with well into the future," said Agency for Health Care Administration Secretary Alan Levine.

The Governor was also joined in Tallahassee by Department of Health
Secretary John Agwunobi, M.D., M.P.H., M.B.A., Department of Elder Affairs Interim Secretary Susan Tucker, Department of Children and Families
Secretary Lucy Hadi, Agency for Persons with Disabilities Director Shelly
Brantley and Dr. Nelson Adams of PhyTrust.

Mrs. Amparo Valdes, a Medicaid participant from Miami who was diagnosed with diabetes, was also in attendance. Under the reformed Medicaid system, Mrs. Valdes and her doctor would enjoy much greater flexibility in managing her care.

The Florida Agency for Health Care Administration last year held a series of
public meetings to engage participants, providers, physicians, the business
community, non-profits, advocates and the media to collect feedback and
ideas for reforming Medicaid. The discussions resulted in many approaches
and strategies that contributed to the formulation of Governor Bush's
proposals to the Florida Legislature.

For more information on Governor Bush's proposal, please visit,
www.empoweredcare.com or www.myflorida.com.

To download a copy of Governor Bush's white paper, click here. 

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The Florida Medical Directors Association represents nearly 250 medical directors, attending physicians, physician assistants, and advanced registered nurse practitioners in Florida’s postacute care continuum including subacute care, hospice, skilled nursing, and assisted living facilities, as well as in continuing care retirement communities. The mission of FMDA is to promote the highest quality care in the postacute care continuum by providing leadership, professional education and advocacy.
 

Contact: Ian Cordes, Executive Director
Florida Medical Directors Association
(561) 371-2586, ian.cordes@fmda.org