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Commentary

New Medicaid Model
Jeb Bush, Washington Times, 12-15-05

Florida Governor Jeb Bush explains how his pilot Medicaid reforms will improve health care for low-income Floridians, while also slowing the growth of Medicaid costs.

Florida's new model will use time-honored market principles to drive better results and place a greater focus on the diverse needs of the 2.2 million vulnerable, elderly and disabled Floridians who rely on Medicaid. It will improve health outcomes of these participants by enhancing their access to quality care and creating flexibility and incentives for providers and consumers to focus on prevention. Florida's Medicaid reform will also stabilize the program's costs while maintaining current eligibility and broadening the scope of services we provide. We will empower consumers with unprecedented choice and unleash the innovative and competitive talents of providers.
The first phase of the reform plan will be implemented in Duval and Broward counties in 2006. More than 200,000 participants in these counties will soon have the opportunity to receive better health care and costs will become more predictable, allowing the state to better manage spending. With legislative approval, we will expand Medicaid reform to the rest of Florida within five years after closely reviewing results and best practices in the pilot counties. Careful monitoring of outcomes and financial impact during the initial phase will allow for adjustments going forward. Transparent results will help to protect beneficiaries and assure legislators that the reforms are delivering promised improvements.
Our vision of Medicaid respects and trusts people to make decisions about their health based on their personal needs. Participants, with the assistance of counselors, will choose the best plan for them. Or, they can choose to opt out of Medicaid plans and use their state-paid premium to purchase insurance in the private market. Under reform, the premiums funded by Medicaid will be risk-adjusted -- higher premiums will be paid for sicker people who use more health services. Medicaid consumers will then have the right amount of resources and the purchasing power to choose a coverage plan or a network of providers offering a service delivery system that best suits their needs.

Governor Bush is taking a real political risk through his Medicaid reforms. If the reforms succeed, however, he will deserve much of the credit for advancing a new policy model.



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