Florida is a national leader in Medicaid quality
On December 3 2020, the the Agency for Health Care Administration announced that the Statewide Medicaid Managed Care (SMMC) 2019 quality scores continue to show improvement, with Florida’s Medicaid health plans performing as well as or better than the national average on 67 percent of quality measures.
“Under Governor DeSantis’ leadership, our Agency remains focused on strengthening the accountability of managed care plan performance,” said Agency for Health Care Administration Acting Secretary Shevaun Harris. “Floridians deserve access to quality health care, and these continued improvements support the Agency’s mission to achieve better health outcomes across the state.”
“Community Care Plan is proud to work together with the Agency, the state’s leadership, and Governor DeSantis to develop and implement innovative initiatives that continue to raise the bar and improve the health and well-being of Floridians that participate in the SMMC program,” said Jessica Lerner, Chief Executive Officer of Community Care Plan.
"These improvements also extended to SMMC Specialty Plans, such as the Department of Health’s Children’s Medical Services (CMS) Health Plan, which under the leadership of Governor DeSantis launched a new delivery model for children with medical complexity in 2019 through a partnership with WellCare,” said Florida’s Deputy Secretary for Children’s Medical Services, Dr. Robert D. Karch. “These strong 2019 results reflect the combination of our core value of high-quality care coordination with new elements of our delivery model such as value-added expanded benefits for children and quality-driven physician incentives.”
“Aetna Better Health of Florida has integrated AHCA’s quality goals into all of our managed care functions,” said Jennifer Sweet, CEO, Aetna Better Health of Florida. “We take these goals seriously – and our Plan’s results reflect this more each year. We are proud to contribute to the successful quality ratings in Florida Medicaid, and we applaud the Governor and the Secretary’s focus on these important measures because they contribute to the overall wellbeing of our members and our communities.”
“Humana applauds the Agency’s relentless commitment to quality on behalf of the Governor’s goals for improving the health care experience for Floridians and value the collaboration we have across the Agency and the SMMC program to drive continuous improvement in overall program quality and health outcomes for the Medicaid enrollees we serve,” said Jaimie White, Regional President, Humana FL Medicaid Programs.
“Magellan Complete Care appreciates the opportunity to work in collaboration with the leadership at AHCA and Governor’s office in making a positive impact in the lives of so many Floridians,” said Joy Bland, VP of Quality for Magellan Complete Care.
“These encouraging results are a testament to the Governor’s efforts in improving health outcomes for Florida’s Medicaid beneficiaries,” said Mike Jones, plan president for Molina Healthcare of Florida. “Molina believes that continuous improvement in quality of care is key to optimizing overall health and wellness while also lowering the overall cost of medical care.”
“Simply Healthcare recognizes the important role we play in improving health outcomes across the state, and we are proud of the tremendous milestone achieved by our state driven by Governor DeSantis’ commitment to ensuring access to quality healthcare for Floridians,” said Holly Prince, Medicaid President, Simply Healthcare Plans, Inc. “We look forward to many more years of ongoing collaboration with the Agency as we continue our shared mission of improving lives and communities.”
“These improvements are a result of SMMC health plan efforts to proactively engage our members in wellness activities and chronic condition management and to develop strong partnerships with high-performing Florida providers,” said Bill Hinsdale, Chief Medicaid Officer of Sunshine Health Plan. “We are proud of the success of the SMMC Program and look forward to our continued partnership with Governor DeSantis and the Agency to improve the health of Florida’s communities.”
“UnitedHealthcare applauds the work that Governor DeSantis’ administration has done collaborating with the MCO’s to create high quality, high value programs that improve the lives of Floridians in the Medicaid program. The Agency for Health Care Administration has created a national model for managed care that supports improvement in quality, lowering healthcare costs, and improve the safety of our healthcare programs,” said Michael S. Lawton, Chief Executive Officer.
This is the fifth full year of the nationally recognized Healthcare Effectiveness Data and Information Set (HEDIS) quality scores being used for the SMMC program, as the National Committee for Quality Assurance (NCQA) uses HEDIS to measure health plans on their levels of care and service. Florida’s Medicaid program is one of the most efficient programs in the country and serves as a national model.
While the health plans have maintained their performance on 11 measures, 28 reported measures now show improvement over last year’s scores including, but not limited to:
•Adolescent Well-Care Visits
•Adult BMI Assessment
•Asthma Medication Ratio – Total
•Breast Cancer Screening
•Controlling High Blood Pressure
•Engagement of Alcohol and Other Drug Dependence Treatment – 18+ years
•Follow-up Care for Children Prescribed ADHD Medication – Continuation and Maintenance Phase
•Immunizations for Adolescents – Combination 1
•Initiation of Alcohol and Other Drug Dependence Treatment – Total
•Lead Screening in Children
•Timeliness of Prenatal Care
•Weight Assessment and Counseling for Children/Adolescents – BMI Percentile
•Well-Child Visits in the First 15 Months of Life – 6+ visits
For more information on the SMMC program, please visit our website at: http://ahca.myflorida.com/medicaid/statewide_mc/index.shtml
The Agency for Health Care Administration is committed to better health care for all Floridians. The Agency administers Florida’s Medicaid program, licenses and regulates more than 44,000 health care facilities and 53 health plans, and publishes health care data and statistics at www.FloridaHealthFinder.gov. Additional information about Agency initiatives is available via Facebook (AHCAFlorida), Twitter (@AHCA_FL) and YouTube (/AHCAFlorida).