Healthcare for Floridians when they need it
A Look At The Numbers provides information on how managed care organizations (MCOs) partner with Florida to provide care for a growing Medicaid population.
Medicaid managed care enables Florida to deliver higher quality care and improve health outcomes for Medicaid recipients while managing healthcare costs.
The care people need, when they need it. That is the model of managed care.
Medicaid in Florida
Florida Medicaid provides healthcare to many individuals facing economic and social barriers to help improve their health and well-being. Medicaid covers 4.5 million Floridians, of which 3.5 million are enrolled in Medicaid managed care.1
Serving Florida since 2006
MCOs have worked with the state of Florida for over a decade, helping to deliver a higher standard of healthcare to millions of Floridians.
Medicaid managed care pilot launches in Florida
Medicaid managed care expands to all Florida counties
Two-thirds of Florida’s Medicaid beneficiaries enrolled in managed care2
Managing costs and risks
Delivering transparency and predictability
With the costs of healthcare rising, MCOs help Florida better plan and manage its budget, while ensuring that a growing number of Medicaid recipients get the quality healthcare they deserve.
Florida MCOs provided estimated Medicaid savings of $420 million in 2016 and $441 million in 2017.7
MCOs use a range of strategies to run cost-effective programs, including helping patients receive preventive services, providing supportive care for members with complex conditions, and managing the provider network.
Florida’s MCOs and the Agency for Health Care Administration are committed to reducing potentially preventable hospital admissions by 22%, reducing hospital readmission by 21%, and reducing preventable emergency room visits by 14%.10
Higher quality care
Improving population health
increase in prenatal care in the first trimester between 2013 and 20178
The managed care model is based on the delivery of quality care that provides services that are medically necessary for people when they need them. MCOs empower members to engage with their own healthcare, providing education around and support for preventive services.
In 2017, 69% of infants had regular well-child visits with their primary care doctors, and 90% of older adults had annual visits with their primary care doctors through Florida Medicaid.8
Between 2013 and 2017, there was also a 9% increase in annual dental visits.10
Overall, MCOs in Florida provide more than 55 additional benefits to people in Medicaid, including substance abuse and mental health treatment, alternative pain management services, doula services, and vaccines for adults.10
Helping states help providers
Through Medicaid managed care, providers benefit as well. MCOs use value-based payment models that incentivize, empower, and reward providers for their quality of care.
MCOs also help maintain strong provider networks and offer clinical support, continuing education, and technological innovations that enable providers to deliver higher quality care.
Managed care in Florida also helps to reduce administrative burdens by allowing high-performing providers to bypass prior authorization and completing credentialing for network contacts in 60 days.10