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Managed care “report cards” will be released in early 2015

Florida’s sweeping experiment to overhaul its Medicaid program is fast approaching its next big step. And that’s trying to explain to those seeking health care coverage how well managed care plans  are performing on a number of health care indicators.

Agency for Health Care Administration officials on Friday unveiled the first glimpse of a report card that will aim to measure the services provided by the HMOs operating in the new managed care environment. The Legislature in 2011 passed a law requiring most Medicaid beneficiaries–from the cradle to the grave–toenroll in managed care. A state website shows that there are 2.76 million people in Medicaid managed care plans. Overall, there are 3.59 million people in Medicaid.

One of the unique requirements under the federal waiver that allowed Florida to move ahead is a mandate to put together a report care that consumers can use. Beth Kidder, assistant deputy secretary for Medicaid operations, said that AHCA expects to hae the report card published on its FloridaHealthFinder.gov website sometime in early 2015.

“This is really the beginning point, not the end point of the transparency we are putting forward,” Kidder told members of the state’s Medical Advisory Committee on a conference call.

The plan is to rate health plans on six main areas, including the treatment of pregnant women, children and those with chronic illnesses. Plans will receive a rating between one and five stars that will be compared to national Medicaid benchmarks.

Kidder stressed that the report card has to be understandable and reader friendly to the public who will use them. “This is a consumer focused report card, not a tool for researchers,” she said.

The first round of report cards will have some limitations. For instance, the data the managed care plans are evaluated on is from 2013, which is before the state completed its mandatory managed care program. Additionally, there are seven health plans that will be included in the report card that no longer participate in the Medicaid program and, therefore, aren’t something Medicaid beneficiaries could enroll in.

Some of the advisory panel members who listened to the presentations did raise questions as to how well the report card will be marketed. Amy Guinan with Florida Legal Services asked about whether dental plans that operate as subcontractors for the managed care plans will be rated. AHCA said the scores will be merged into the health plan’s overall performance. Catherine Moffitt of the Florida Association of Health Plans asked AHCA if it planned to change the wording of the managed care contracts the plans signed with the state to align with the items that are highlighted in the report cards. Kidder told Moffitt that the main goal of the report cards was to come up with criteria that was the most “meaningful” to consumers.

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