Luis Mosquera: A champion for patients, providers in Florida health care

Meeting patient needs is the top priority for health care providers, and to maximize success they need expert support.

They deserve a champion who understands all the business-side nuances and works to manage the details. For the providers in our network and their patients, we are that champion.

Health Network One is a leader in managed care, pioneering approaches that ensure the best outcomes for Florida’s Medicaid recipients, especially children, by preserving a system of care that keeps patients and providers at the center of everything we do.

Through a network of more than 5,000 providers — including more than 3,800 delivering speech, physical and occupational therapy services — we help providers deliver quality treatment for more than 2,000,000 of Florida’s most vulnerable patients, many of them children. With an impressive 95% retention rate both among our 200-plus Health Network One employees and among our providers, our trusted network has grown to become the largest in Florida and one of the largest in the country over the past 20 years.

Constant review and analysis drive our success to ensure care delivery, innovative alternative payment programs and essential cost-savings for the long-term viability of Medicaid in Florida while continuing to advocate for our provider network, constantly drawing inspiration from the passion with which they advocate for their patients.

Collaboration with providers drives our innovative approach. Our ongoing Medical Advisory Committee is comprised of six Florida licensed therapists representing the spectrum of providers, including those from urban and rural areas, large and small practices and across all our therapy types. The committee convenes quarterly to refine approaches to utilization management, patient care, reporting and more. Representatives from our senior leadership team join the committee drawing on the expertise from our medical director, a physical medicine and rehabilitation physician, and our associate medical director, a practicing community pediatrician.

We also collaborate and partner with our health plans and state agency partners to deliver a quality provider network that ensures the state’s limited Medicaid funds can provide the highest level of care at a lower cost. This is done through our value-based provider reimbursement model that is not just different, it’s better. Our approach lowers the cost by matching the plan of care to the patient’s specific clinical need, with a goal of preventing overutilization that would undermine Medicaid’s financial viability. Our process routinely passes its regular audits by the Agency for Health Care Administration demonstrating that we not only meet, but often exceed state standards.

And, when special circumstances arise, we respond. COVID-19 placed unprecedented demands on our providers, including an immediate pivot to telehealth for delivery of therapies. Health Network One quickly provided its network with a robust, turnkey solution at no charge and delivered approximately $1 million in PPE donations across our networks.

Health Network One has a well-established track record of care delivery through a proven alternative payment system that provides bona fide savings to both its health plan customers and the state of Florida while ensuring our providers receive the personalized care they deserve, and Florida’s children get the individualized care they require.

As the Agency for Health Care Administration welcomes a new leader, we look forward to working together to champion an innovative system that puts patients and providers first.

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Luis Mosquera is the chief executive officer of Health Network One and has over 25 years of experience in the health care field in a variety of disciplines and capacities that have provided him with a unique perspective of the industry and its needs.