Florida’s Medicaid reform pilot is saving money, UF study finds

By Jill Pease
Dr. Jeffrey Harman

Dr. Jeffrey Harman

Health care plans in the Florida Medicaid Reform Pilot project have done a better job of controlling costs than Florida’s traditional Medicaid program, according to a University of Florida study. An initial estimation suggests the reform pilot reduced costs by about 18 percent, had expenditures increased at the same rate as experienced in the non-reform counties.

The Medicaid reform project has lowered expenditures in participating counties by about $200 per member per month for Medicaid enrollees who qualify under the Supplemental Social Security Income program. For enrollees who receive Medicaid through Temporary Assistance for Needy Families, expenditures were lowered by about $30 per-member per-month.

The study findings appeared online ahead of print in the journal Health Services Research.

Medicaid, the public health insurance program for people with low income, is one of the largest chunks of U.S. states’ budgets, so most states are looking for ways to trim costs — especially given the expansion of Medicaid under the Affordable Care Act, said lead investigator Jeffrey Harman, Ph.D., an associate professor and the Louis C. and Jane Gapenski term professor of health services administration at the PHHP department of health services research, management and policy.

“Many other states are considering reforms to their Medicaid programs that are similar to Florida’s,” he said.

The Florida Medicaid Reform Pilot was launched in 2006 in Broward and Duval counties and later expanded to Baker, Clay and Nassau counties. In 2011, the Florida Legislature voted to expand the Medicaid Reform Pilot statewide. Implementation begins May 1. Enrollees can select an HMO or a provider service network to manage their care.

The UF team compared four years of reform pilot cost data for Broward and Duval counties with Medicaid costs in Hillsborough and Orange, two Florida counties that are similar in size and demographics but were not part of the reform.

Researchers found that while both the HMO and provider service network plans in the reform resulted in lower expenditures, the provider service networks saved more money per member per month — about $7.

“It wasn’t a huge difference, but it was a difference that would result in real savings to the Medicaid program,” Harman said.

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