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Rick Scott’s healthcare commission narrows its focus to Medicaid, hospitals only

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What started out as a review of “taxpayer-funded” healthcare commission has been, so far, limited to Medicaid only.

And apparently, hospitals only, even though the executive order creating the blue ribbon panel mentions insurance companies, managed-care plans and healthcare providers.

The Commission on Healthcare and Hospital Funding held its second meeting in Orlando on Tuesday and continued to focus only on hospitals and has not discussed the role that insurance companies or managed-care plans–some of which also received Medicaid dollars–play in the state’s healthcare delivery system.

Though Medicare, veterans’ health, and state group health insurance are taxpayer-funded programs that provide healthcare benefits, Department of Health Secretary and state surgeon general John Armstrong said the focus would be on Medicaid, Low Income Pool and graduate medical education.

Armstrong told commission members the purview of the committee is limited to those areas because those are the ones the state can control, though that’s not completely accurate given Medicaid is under the auspices of the federal government and the state government.

The Medicaid program was $24 billion in fiscal year 2014-15. The federal government pays 60 cents of every dollar and the state picks up the remaining portion.

The Low Income Pool–also Medicaid–is supplemental funding made possible only through a waiver that must be approved by the federal government. In 2014-15 the Low Income Pool was set at $2.167 billion plus and funded mostly through county dollars–$867.6 million–and federal dollars–$1.291 billion. There were $9.1 million in state dollars in the LIP program in 2014-15.

Medical physician education used $204.5 million in LIP dollars in 2014-15.

Overall, the state group health insurance is estimated to cost $2.2 billion in 2014-15, of which $1.67 billion in paid for by the “employer” or the state of Florida.

In his executive order creating the commission Gov. Rick Scott noted it was “necessary to review Florida hospital, insurance and healthcare providers and how any taxpayer money and government policies contribute to the quality, profits, (including executive compensation packages) and losses of these institutional, and their impact on the affordability, access and quality of healthcare services for Florida families …”

Commission chairman Carlos Beruff told Florida Politics last week that he thought the commission’s focus would narrow to hospitals solely.

At the conclusion of the meeting Armstrong suggested that the commission after each meeting proclaim findings they made. Armstrong said he wanted to compile a list of findings–such as that 70 percent of health care is paid for by the government, which commission members discovered after the first meeting in Tallahassee–and have it available for the third meeting. He said he would like members to also approve those findings.

Armstrong also suggested that, while many of the discussions to date have focused on dollars and cents, the conversations should begin to focus on quality as determined by patients and communities.

The commission is slated to meet again June 4 in Tallahassee. The date coincides with the upcoming special session.

There was a request for the commission to hold a meeting in South Florida.

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