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Heath plans lining up for state's new medicaid system - Electromagnetic Interactive Whiteboard Manu by guo ping





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Heath plans lining up for state's new medicaid system - Electromagnetic Interactive Whiteboard Manu by
Article Posted: 06/16/2012
Article Views: 79
Articles Written: 1013
Word Count: 596
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Heath plans lining up for state's new medicaid system - Electromagnetic Interactive Whiteboard Manu


 
Business,Business News,Business Opportunities
Preparing for Florida's shift to a statewide Medicaid managed-caresystem, 20 health companies and organizations are interested incompeting for contracts to serve seniors who need long-term care. Potential bidders faced a deadline last week to submit nonbindingletters of intent that signaled their interest in the long-termcare program, as the state Agency for Health Care Administrationgets ready to move forward with a lengthy contracting process. Those expressing interest ranged from major managed-care industryplayers, such as Humana and WellCare, to smaller regionalorganizations, such as Brevard Alzheimer's Foundation Inc., andMiami Jewish Health Systems. The list of potential bidders only reflects health plans interestedin the long-term care portion of a statewide managed-care system.AHCA has not sought similar letters of intent for plans hoping toserve the broader Medicaid population, such as children and women.

Nevertheless, the list of potential long-term care bidders is thefirst of its kind since Florida lawmakers last year approved a planto transform Medicaid. That plans remains subject to federalapproval, but AHCA is preparing to start the contracting process. Under the system, the state would be divided into 11 regions, withmanaged-care plans competing for contracts in each region. Planscould win contracts in multiple regions. The list of potential long-term care bidders provides a glimpse ofhow different parts of the state could be served --- and howcompanies and organizations view the markets.

Seven health plans submitted letters indicating they are interestedin competing in all regions. They are American Eldercare,Amerigroup, Humana, Simply Healthcare, Sunshine State Health Plan,UnitedHealthcare and WellCare. Those seven also are the only plans that indicated interest incompeting in a massive region of 14 counties that spans from Holmesand Washington counties in the Panhandle to Madison and Taylorcounties in the Big Bend. During the legislative deliberations last year, questions wereraised about the number of health plans that would want to dobusiness in such relatively rural areas.

In the end, lawmakersdecided that contracts would only be awarded to two plans in the14-county region. Similarly, two plans would win contracts inanother region of the western Panhandle. By comparison, 17 companies and organizations submitted lettersindicating they are interested in long-term care contracts in aheavily populated region made up of Orange, Osceola, Brevard andSeminole counties. Those potential bidders range from large HMOs tocompanies involved in the nursing-home industry to the BrevardAlzheimer's Foundation. Similarly, 15 plans indicated interest in a region that includesMiami-Dade and Monroe counties.

Lawmakers last year said AHCA couldaward as many as 10 contracts in that region --- the most of anyregion in the state. AHCA plans this summer to issue what is known as an "invitation tonegotiate" that is a key first step in the contracting process forlong-term care plans. It hopes to start enrolling Medicaidbeneficiaries in the new system in 2013, with statewide enrollmentfinished by April 2014, according to an AHCA timeline. The process for shifting the broader Medicaid population intomanaged care would take longer, with an invitation to negotiateissued in January 2013 and full statewide enrollment by April 2015.

Exact dates for the changes are difficult to pinpoint, at least inpart because it is unclear how long the federal-approval processcould take. Republican leaders argue a statewide managed-care system would helphold down costs and better coordinate health coverage for Medicaidbeneficiaries. But Democratic lawmakers and some patient advocateshave fought the move, arguing that for-profit HMOs could make itharder for beneficiaries to get needed care.

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