As part of the Florida Agency for Health Care Administration’s (AHCA) request to extend its 1115 Medicaid waiver, the AHCA released preliminary data showing that the state’s Medicaid reform pilot reduces service utilization.  AHCA officials caution against using the data for policymaking, noting that the data do not account for the quality or appropriateness of care.  The reform pilot currently operates in Baker, Broward, Clay, Duval, and Nassau Counties, enrolling beneficiaries in private managed care plans rather than the state’s traditional fee-for-service (FFS) plan.

From the report:

Florida's Medicaid Reform is a comprehensive demonstration that seeks to improve the value of the Medicaid delivery system. The program is operated under an 1115 Research and Demonstration Waiver approved by the Centers for Medicare and Medicaid Services (federal CMS) on October 19, 2005. State authority to operate the program is located in Section 409.91211, Florida Statutes (F.S.), which provides authorization for a statewide pilot program with implementation that began in Broward and Duval Counties on July 1, 2006. The program expanded to Baker, Clay and Nassau Counties on July 1, 2007. Through mandatory participation for specified populations in managed care plans that offer customized benefit packages and an emphasis on individual involvement in selecting a health plan option, the State has gained valuable information about the effects of allowing market-based approaches to assist the state in delivering services to Medicaid beneficiaries.

Full report: Florida Medicaid Reform Extension Request 1115 Research and Demonstration Waiver (PDF | 400MB)  

Florida Agency for Health Care Administration (AHCA). Florida Medicaid Reform Extension Request 1115 Research and Demonstration Waiver.