Newspaper article The Florida Times Union

MEDICAID; Reform the Reform

Newspaper article The Florida Times Union

MEDICAID; Reform the Reform

Article excerpt

The exodus of doctors from Florida's Medicaid reform pilot program is a cause for concern.

Nearly one-fourth of Medicaid doctors in Broward and Duval counties have left the pilot program over low pay and restrictions on treatments in less than two years, according to The Associated Press.

If that doesn't stop, there won't be enough doctors.

That's one of several problems facing the fledgling reform program. While state officials are addressing that, they should review some comments made during the Medicaid conference last fall in Tampa.

The attendees - about 300 people, mostly medical professionals and others with a stake in the issue - weren't necessarily opposed to some type of reform.

But many wanted some of the kinks worked out.

WHAT KINKS?

When Medicaid recipients in the pilot programs were taken out of "fee for service" and placed in "managed care" plans, conferees were told, many had to leave family doctors and specialists they had used many years and trusted.

Sometimes, they no longer could get medicine that had worked for them in the past.

Many recipients didn't know they were supposed to pick a plan, conferees were told - and others had trouble understanding their options. As a result, about a third had to be assigned to plans by the state.

The state also was offering credits for healthy habits. But some were not aware of that, either, so most accrued credits haven't been used.

Meanwhile, physicians have to fill out more paperwork than in the past - and they aren't reimbursed enough to pay their costs.

To make up their Medicaid losses, they have to charge other patients more. Here's an analogy used by a discussion group member at the Tampa conference:

A MEDICAID PARABLE

If a gasoline station owner is told he has to charge $1 a gallon for Fords, and gas costs him $2, he must make up the difference by charging everyone else more.

But pretty soon, to save money, owners of other cars will start going to stations that don't serve Fords. …

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