Agency for Health Care Administration Secretary Elizabeth “Liz” Dudek just finished implementing a statewide mandatory managed care program for the fifth largest Medicaid program in the nation.
What does she plan to do now?
Dudek rattles off an ambitious “to do” list s that she said she’d like to accomplish in the next four years as she hopes to “ride out” Florida Gov. Rick Scott’s second term in office as agency secretary.
“After that,” Dudek says, “There are probably some other people who should be at the helm.”
In a year-end interview with Saintpetersblog in her Tallahassee office on Monday Dudek said that she’d like to make health care budgeting a little more “cut and dry” by implementing a DRG–or diagnostic related group–reimbursement system for health care services paid for by Medicaid.
Dudek said DRGs could be implemented for hospital outpatient services, nursing home care as well as reimbursement for intermediate care facilities for the developmentally disabled.
Currently Medicaid reimburses for these services using a cost-based per diem system, meaning facilities receive payments based on how much it cost them to treat the patient while in the hospital. Under DRGs, providers are paid a fixed amount based on a patient’s diagnosis. If care can be provided for less than the DRG, then it makes money. If treatment exceeds the DRG, the facility loses money.
DRGs are currently used for hospital inpatient services.
Other things on Dudek’s to-do list include simplifying online licensing in the Division of Health Quality Assurance which regulates 45,000 health care facilities throughout the state and retooling the agency so staff to reflect the changes in the Medicaid program which has been set up to pay and monitor a fee for service delivery system, not a managed care system.
Dudek is a rarity in Tallahassee: she was an agency secretary under Gov. Charlie Crist as well as Gov. Scott. While she had reported directly to two different governors as an agency secretary her lengthy career has given her opportunities to meet with Govs. Lawton Chiles and Jeb Bush, also.
Dudek said Scott–who has an extensive health care background–wants “all the details” when they meet to discuss progress. “There’s no blowing over an issue,” she said, laughing. “He’s wants to know all the details.”
She examined the DROP program when it was first established but Dudek said she didn’t enroll in it because she didn’t like the idea of being forced to retire within a certain time frame.
“I like the flexibility,” she said.”I figure I’ll be here as long as I do a good job or as long as i want to be here.”