GOVERNMENTFlorida doctors wary of Medicaid overhaulSome say the state plan of shifting more patients into managed care is a bad idea, but others see opportunity.By Amy Snow Landa, amednews correspondent. Jan. 2/9, 2006. Florida physicians have mixed views on the state's Medicaid reform plan, which the state Legislature approved Dec. 8 and Gov. Jeb Bush is touting as the most ambitious attempt to redesign Medicaid since the program's inception. Some physicians are concerned that the plan transfers more Medicaid dollars and administrative control to HMOs and other private entities that set up managed care plans. But other doctors would like to be among those entrepreneurs, said Arthur Palamara, MD, a vascular surgeon in Hollywood, Fla., and past president of the Broward County Medical Assn. As part of its Medicaid reform plan, the state is encouraging physicians and hospitals to set up provider service networks that would compete with HMOs and other insurers in offering managed care plans to Medicaid patients. "It does create an opportunity for small entrepreneurs to go ahead and offer up a capitated network and to provide a source of treatment for beneficiaries," Dr. Palamara said. Under the federal waiver approved in October 2005, Florida will create a pilot program that pays managed care plans a risk-adjusted premium and allows them unprecedented flexibility to decide the amount, scope and duration of covered benefits for Medicaid enrollees. Florida's waiver is the first of its kind and could have a far-reaching effect on the state's program, said Joan Alker, senior researcher at Georgetown University's Health Policy Institute. "It is attempting to move Medicaid from a program that guarantees beneficiaries a defined set of benefits to a program where they are guaranteed a fixed amount of money to purchase a package of services that may or may not meet their needs." [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2006 American Medical Association. All rights reserved.
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The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment. Meeting coverage - Slideshow Feature articlesHealth reform review The Massachusetts experience Litigation stress Being sued is personal as well as professional Comprehensive coverage
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