Study finds Florida Medicaid program confusing
14 10 08 - 16:58
Study calls Broward Medicaid program confusing
A study of a closely watched pilot program said Broward Medicaid recipients have difficulty interpreting their choices.
By JOHN DORSCHNER
jdorschner@MiamiHerald.com
A major study being released Tuesday reports that more than half the Medicaid participants in a reform pilot program in Broward and Duval counties ``had trouble understanding the plan.''
The study, by policy journal Health Affairs, surveyed 1,848 persons in the two counties in 2006 and 2007. It found that three in 10 didn't even know they were supposed to choose a health plan and many others were confused by the options.
The pilot, created by the Jeb Bush administration in 2006, is being closely watched by health experts nationwide because it attempts to offer both lower cost and better service by privatizing the government healthcare program intended for the poor and disabled.
The concept was designed to allow recipients to choose among plans offered by private insurers, under the theory that would increase competition among the plans and push them into offering better benefits.
That means the programs ''hinge on the ability to translate complicated healthcare information for consumers,'' the seven co-authors wrote, ``and then help consumers use that information to make informed healthcare decisions. Without a well-informed consumer, a fundamental piece of the competitive model is missing, jeopardizing hoped-for efficiencies and cost savings.''
Janet Burnett, a disabled Sunrise nurse, told The Miami Herald she had no problem choosing a plan because of her background, but if it hadn't been for her training, ``it would have been terribly difficult.''
Of the 764 persons interviewed in Broward, 56.3 percent said it was hard to understand the information about plans.
The authors included researchers from the Urban Institute, the Kaiser Family Foundation and R. Paul Duncan and Allyson G. Hall of the Florida Center for Medicaid and the Uninsured at the University of Florida.
The findings backed up what Florida CHAIN, a healthcare advocate for the poor, has said for some time.
''A lot of people were complaining they couldn't find out the preferred drug lists for the different plans,'' said Laura Goodhue, CHAIN's executive director.
Maria Riles, account manger for ACS' Florida Choice Counseling Program, which advises persons in the pilot program, said that starting in August 2007, the company has polled 400 persons in the program each month and 90 percent say that the counseling is ``helpful to them.''
Riles said it's true that the counselors don't now have information on the plans' preferred drug lists, but that will change later this month when a new state database becomes available to them.
Tuesday's report was the latest in what has become a battle of experts.
Earlier this year, a study by a free-market think tank, the James Madison Institute, found the program was working well, contradicting critical studies by Georgetown University and the inspector general of the Florida Agency for Healthcare Administration.
Daniella Levine, head of the Human Services Coalition, an advocacy group for the poor, said, ``Medicaid is considered our healthcare safety net program, and yet is covering few adults in Florida.
The guidelines are less generous than many other states.''
She said Medicaid's costs in Florida are high because many elderly persons move down from the North and end up in nursing homes, where their extended stays are paid for by Medicaid.
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