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Medicaid grew 13% in past year

7/1/2009 © Health News Florida

Spurred by the weak economy and high unemployment, Florida Medicaid enrollment grew by more than 13 percent in the past year to almost 2.5 million, according to new data reported by the Agency for Health Care Administration.

Still, only two of three Floridians who qualify for Medicaid were enrolled as of May 31, according to an analysis of the data by Deutsche Bank Securities Inc.  

The past year also saw a continued migration to HMOs from Medipass, the non-HMO form of Medicaid, in which a patient’s care is managed by the primary care physician. Two companies -- Centene and Molina -- acquired primary-care networks active in Medicaid with the aim of shifting their members to the full-risk HMO side, which brings in more money, Deutsche Bank said. 

"We assume Medipass membership will continue to (slide) as the state continues to shift members to at-risk HMO products," the analysts' report said.

Another shift is taking place as the state’s largest Medicaid HMO contractor, WellCare Health Plans Inc., moves out of the major counties that are part of the state’s “Reform” pilot project, Broward and Duval. The pullout was essentially completed in May in Broward but was delayed in Duval to give the state more time to find alternative plans.

WellCare has dropped more than 22,000 members in Broward and about 4,500 in Duval. The remaining 24,000 WellCare enrollees in Duval should be moved out by the end of the summer.

WellCare told the state it was leaving the pilot because budget cuts had made the payments too low for this stage of the project, when plans assumed more financial risk for enrollees’ medical needs.

However, other companies appear willing to accept the risk. Centene and AmeriGroup have signed up most of WellCare’s Broward enrollees.

While WellCare’s market share dropped from almost 26 percent to 24 percent with the pull-out, it remains the largest Medicaid contractor in Florida. AmeriGroup is next with 11 percent, followed by UnitedHealth at 6 percent, Centene at 8 percent, and Humana and Molina, both 3 percent.

Centene and Humana recorded the largest Medicaid growth in the past year in Florida. United and Molina had the largest enrollment drops.