Florida Medicaid Reform Evaluation

1. Florida Medicaid Reform Evaluation R. Paul Duncan, Ph.D.ChairDepartment ofHealth Services Research,Management & PolicyUniversity of Florida Technical Advisory Panel Meeting Tallahassee, FL December 18, 2008

2. Florida Medicaid Reform Principles Patient responsibility and empowerment Marketplace decisions Comparability of public and private coverage mechanisms Sustainable growth rate

3. What�s New? More choices for enrollees HMOs and PSNs customized benefit packages opt-out to employer-sponsored plans Choice Counseling Enhanced Benefits Rewards program Risk-adjusted rates Low-Income Pool

4. UF Evaluation UF contracted by AHCA to conduct five-year evaluation study The UF evaluation studies are examining whether or not Reform achieves its stated objectives to: increase the number and types of plans available provide access to services not previously covered and improve access to specialists improve enrollee outcomes determine enrollee selection to opt-out to employer sponsored plans and the value of those plans increase enrollee satisfaction increase access for the uninsured through the Low-Income Pool Several additional projects and collaborations also initiated

7. Quality of Care, Outcomes, and Enrollee Experience Analyses Allyson Hall, Ph.D. R. Paul Duncan, Ph.D.

8. Enrollee Experiences: CAHPS-Like Telephone Surveys Based on the Agency for Healthcare Research and Quality�s (AHRQ) �Consumer Assessment of Healthcare Providers and Systems� (CAHPS) model associated with the HMO Report Card Goal: to measure health care experiences and satisfaction levels in Broward and Duval Counties prior to and throughout the implementation of Medicaid Reform

9. CAHPS-Like Telephone Surveys The �Benchmark� Survey Broward and Duval Counties Fielded Fall/Winter 2006 5,767 completed interviews The �Year 1 Follow-Up� Survey Broward and Duval Counties Baker, Clay, Nassau Counties (Benchmark Survey for expansion counties) Fielded Winter 2007/2008 7,206 completed interviews

10. In a Context of Making Choices, Enrollee Satisfaction Matters The survey instrument measured respondents�: plan enrollment process and coverage, relationships with their providers, overall satisfaction and rating of providers and health plans, ability to access care and health care utilization, perception of the level of courtesy, respect, and helpfulness of office staff, ability to communicate with healthcare providers, health literacy, health and wellness behavior, and health status

11. Very preliminary data - starting our analysis by trying to understand various relationshipsVery preliminary data - starting our analysis by trying to understand various relationships







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20. Select Satisfaction Measures:SSI, Broward Only

21. Select Satisfaction Measures:Non-SSI, Broward Only

22. Select Satisfaction Measures:SSI, Duval Only

23. Select Satisfaction Measures:Non-SSI, Duval Only

24. Select Satisfaction Measures:PSN, Broward Only

25. Select Satisfaction Measures:HMO, Broward Only

26. Select Satisfaction Measures:PSN, Duval Only

27. Select Satisfaction Measures:HMO, Duval Only

28. Fiscal Analyses Jeff Harman, Ph.D.

29. Fiscal Analysis (Currently Underway)

30. Expenditure Comparison Compares pre-Reform PMPM expenditures to Reform PMPM expenditures all Reform-eligible compared to Reform enrollees, broken down by SSI vs. TANF Broward vs. Duval HMO vs. PSN for Reform period SSI/TANF and HMO/PSN for Broward and Duval separately Actual Reform PMPM expenditures will be compared to Predicted expenditures controlling for expenditure trends in control counties (PSN and HMO) and certified capitation rates (HMO)

31. General Observations

32. Q & A

33. For Further Information Paul Duncan, Ph.D. Principal Investigator Department of Health Services Research, Management & Policy College of Public Health & Health Professions University of Florida PO Box 100195 Gainesville, FL 32610-0195 Telephone: (352) 273-6073 Website: http://mre.phhp.ufl.edu/ Email: mre@phhp.ufl.edu AHCA Florida Medicaid Reform Website: http://ahca.myflorida.com/Medicaid/medicaid_reform/index.shtml

Florida Medicaid Reform Evaluation

Florida Medicaid Reform Evaluation

Presentation Transcript

Florida Medicaid Reform Roberta K. Bradford Deputy Secretary for Medicaid

Health Care Reform and Medicaid

Florida s Medicaid Reform

Medicaid “Reform” and Mental Health

Florida’s Medicaid Reform

Florida Medicaid Update

Medicaid Reform and Expansion

Medicaid Reform: The Medical Side

Medicaid Reform Managed Care Study

Florida Medicaid Update

Medicaid Reform Introduction

Medicaid Reform in Florida: Overview and Evaluation

Pre-Conference: Medicaid Reform Primer

The Affordable Care Act: Putting Reform into Medicaid and Medicaid into Reform

Evaluating Medicaid Reform in Florida: Early Findings

Medicaid Reform

FLORIDA MEDICAID

System Reform Efforts in Medicaid

Florida Medicaid Planning Attorney

Putting Reform into Medicaid and Medicaid into Reform: A Two-Way Street

Governor Fletcher’s Medicaid Reform Initiative

Florida Medicaid Reform