Managed care plans bid for health care contracts

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Eyeing billions of dollars in future state business, 20 managed-care organizations have taken a key step to compete for contracts in a revamped Medicaid system, according to a list released Tuesday by the Florida Agency for Health Care Administration, reports Jim Saunders of the News Service of Florida.

The contracts, which are expected to be awarded later this year, are part of a move to eventually enroll almost all Medicaid beneficiaries statewide in managed-care plans. 

HMOs and provider-service networks, another type of managed care, submitted detailed documents — somewhat akin to bids — that the Agency for Health Care Administration will use in negotiating and, ultimately, awarding contracts. The health plans are competing for contracts in 11 different regions of the state.

Five major industry players — Coventry Health Care of Florida, Humana Medical Plan, WellCare of Florida, Sunshine State Health Plan and UnitedHealthcare of Florida — are seeking contracts in each region, according to the list. Other plans are targeting fewer areas.

Lawmakers and Gov. Rick Scott approved controversial legislation in 2011 to move to a statewide managed-care system, contending it would help hold down costs and improve the coordination of services for Medicaid beneficiaries. AHCA in January chose health plans to provide Medicaid services to seniors who need long-term care.

But the list released Tuesday deals with selecting health plans to serve the broader Medicaid population. While 20 managed-care organizations filed the documents, some made more than one type of submission as they also seek contracts for what are known as “specialty” plans. Those plans involve serving specific groups, such as people with HIV/AIDS.

AHCA will award varying numbers of contracts by region. As an example, it will award contracts to two health plans in a western Panhandle region but could award as many as 10 in a region that includes Miami-Dade and Monroe counties.

The state in 2011 began seeking federal approval of the statewide managed-care system. It has received approval for shifting long-term care beneficiaries into managed care, and the Obama administration in February indicated it also would approve the changes for the broader Medicaid population.

Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including SaintPetersBlog.com, FloridaPolitics.com, ContextFlorida.com, and Sunburn, the morning read of what’s hot in Florida politics. SaintPetersBlog has for three years running been ranked by the Washington Post as the best state-based blog in Florida. In addition to his publishing efforts, Peter is a political consultant to several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella.