UF to Rate State's Medicaid Reforms; Study Will Follow Patients from Both the Old and New System

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Byline: URVAKSH KARKARIA

University of Florida researchers have received a $2.5 million contract to develop a report card on the outcome of Florida's new high-profile plan to reform Medicaid.

During the five-year study, UF investigators will, among other things, grade the plan's fiscal impact and measure the satisfaction, quality of care and outcomes experienced by enrollees and health-care providers as the reform is implemented.

The study, commissioned by the Florida Agency for Health Care Administration, will "show us both periodically and over the long term how well Medicaid reform is doing" in meeting its goals, AHCA spokesman Jonathan Burns said Monday.

The reform plan, OK'd by the state legislature in December, shifts most Medicaid recipients into managed care systems that resemble the type of programs offered by employers. Instead of the current "fee-for-service" system, the state is encouraging the creation of Health Maintenance Organizations and local networks of doctors and hospitals known as Provider Service Networks. Medicaid recipients will be offered a choice of providers and the state will pay premiums to the providers, less for those diagnosed as healthy and more for those with illnesses.

The plan is expected to start in July, targeting about 110,000 Medicaid recipients in Duval County. Baker, Clay and Nassau counties, which have about another 20,000 Medicaid recipients, will be added in 2007. Statewide implementation comes in 2011.

Shands HealthCare, the Gainesville-based parent of Shands Jacksonville hospital, expects several thousand Medicaid recipients to enroll in its provider service network as part of the reform program. Shands' network of doctors and hospitals, operated along with local UF physicians, will include three to four area hospitals and more than 320 physicians.

The UF research team will study whether Medicaid "is actually able to deliver more service, holding quality constant, for lower cost or not," in Duval and Broward, where the reform program will first be implemented, vs. counties where the program is not conducted, said Paul Duncan, the study's principal investigator and chairman of the department of health services research, management and policy in UF's College of Public Health and Health Professions.

Researchers will conduct surveys on enrollee satisfaction. The team will also follow a "relatively small number" of Medicaid enrollees over an extended period of time, interviewing them about their experiences multiple times, Duncan said. …