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Medicaid Health Plans Get Mixed Grades

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Managed care plans that participate in Medicaid and the Florida KidCare program received mixed grades on a “scorecard” released Thursday by the Trump administration. 

The scorecard examines how Medicaid and, where applicable, KidCare, performed across a number of health-care categories.

It showed that health plans fared well in areas such as breast-cancer screenings and annual well-care visits for teenagers, while Florida trailed other states when it came to mental-illness treatment and emergency room visits. Based on 2018 data collected by the federal government, the report examined the performance of 17 managed care plans that cover patients in Medicaid, the safety-net program for low income Floridians.

The scorecard also looked at plans that offer services in Kidcare, a subsidized health-insurance program for children who don’t qualify for Medicaid. Among the key findings were that Medicaid managed-care plans in Florida exceeded the median for breast-cancer screenings in women between the ages of 50 and 74.

Nationally, the median percentage of women in that age bracket who received mammograms was 54.6 percent. In Florida, the median rate was 58.2 percent. Florida managed care plans also outperformed the median rate of people ages 12 to 21 who received annual well-care visits.

Nationally, the median rate of children who received well-care visits was 48.9 percent, while in Florida it was 57 percent. Florida did not do as well, though, on other measures. Florida Medicaid and KidCare fell below the national median when it came to follow-up hospitalizations for mental illnesses for children and adults.

The goal is for adults and children with mental illnesses to have visits with mental-health providers within 30 days of discharge. For adults with mental illnesses, the national median was 38 percent for follow-up visits within the recommended time frame.

But in Florida, 30.5 percent of adults were seen within the time frame. Florida Medicaid and KidCare managed-care plans also fared worse than their national counterparts when it came to the percentage of live births where babies weighed less than 5.5 pounds. While the national median was 9.1 percent, the Florida median rate was 10 percent.