Florida Blue

U.S. Department of Health and Human Services

From a tailgating party with Gator fans in Gainesville to a beer festival in Pensacola, Floridians had plenty of opportunities Saturday to get in-person help signing up for health insurance under the Affordable Care Act. And as the second year of enrollment kicks off, U.S. Health and Human Services Secretary Sylvia Burwell is making a swing through Florida today to help get the word out.  

Burwell will make a stop in Tampa Monday morning at the Navigation Lab at the University of South Florida; she will be in Miami this afternoon.

HealthSpot

There was a time when you got sick, you waited to see the family physician.

But then came the "Doc In A Box" clinics, where you went without an appointment, at night and on weekends. And it only got easier when mini-clinics began popping up in neighborhood pharmacies.

Well, these convenient medical visits are taking the next step. Clinic "kiosks" will soon be connecting Floridians and physicians via video screens and interactive tools.

Federal officials are recognizing health insurer Florida Blue for its significant improvements in addressing the childhood obesity epidemic.

Earlier this week, the U.S. Department of Housing and Urban Development and the U.S. Department of Agriculture awarded the Florida Blue Foundation at a ceremony in Cleveland.

Got Insurance? You Still May Pay A Steep Price For Prescriptions

Oct 13, 2014

Sandra Grooms recently got a call from her oncologist’s office. The chemotherapy drugs he wanted to use on her metastatic breast cancer were covered by her health plan, with one catch: Her share of the cost would be $976 for each 14-day supply of the two pills.

“I said, ‘I can’t afford it,’” said Grooms, 52, who is insured through her job as a general manager at a janitorial supply company in Augusta, Ga. “I was very upset.”

Just in time for Medicare's open enrollment season, a Florida-based HMO has won the federal government's coveted  five-star rating, a rare honor that brings more than bragging rights. Such plans receive the freedom to enroll new members all year long. 

The winner, CarePlus Health Plans Inc., is a subsidiary of Humana Inc., Florida's largest Medicare vendor. Humana did well in the quality ratings, too,  but was outscored by the little plan it bought in 2005.

The parent company of Florida Blue is teaming with a major Latin American health business to open three primary-care clinics in Miami-Dade County next year, the Miami Herald reports.

Kaiser Health News

Any doubt that Florida’s largest health insurer wants to expand its reach was quashed by its chief executive Wednesday, when he heralded the success of its new umbrella company and outlined ambitious plans for growth.

GuideWell, launched as a parent of Florida Blue, reaches more than 15 million people through its insurance, consumer, health care and government administration products, Chairman and CEO Pat Geraghty told participants at the Medifuture conference in Tampa.

Less than half are traditional Florida Blue policy holders.

The retirement of Florida Blue’s longtime lobbyist is generating accolades from everyone from Gov. Rick Scott to advocates for disabled children, the Florida Times-Union reports.

 Just seven of the 91 entrepreneurs that pitched a health care startup are getting a boost from Healthbox Tampa, a business incubator that provides seed money, office space and partnerships with health care providers, the Tampa Bay Times reports.

FL Blue Premiums Up Nearly 18 Percent

Aug 1, 2014

Florida Blue, the state’s largest health insurer, is increasing premiums by an average of 17.6 percent for its Affordable Care Act exchange plans next year, company officials say.

The nonprofit Blue Cross and Blue Shield affiliate blames higher health costs as a result of attracting older adults this year who previously lacked coverage and are using more services than expected.

Florida insurance regulators plan to release rate information for all companies next week. The exchange plans cover individuals who aren’t covered by employer-based policies.

Insurers: 2015 Exchange Rates Could Spike

Jul 31, 2014

State insurance officials are preparing to release figures next week on how much health plans will cost under the Affordable Care Act for 2015, and rate increases seem inevitable as insurers say their new consumers are older and sicker than anticipated.

FL Blue Signals Rate Hikes Ahead

Jul 21, 2014
Kaiser Health News

Florida Blue, the state’s dominant health insurer, snagged more than one in three consumers on the health law’s exchange this year, but many could face rate hikes as the carrier struggles with an influx of older and sicker enrollees, said the company’s top executive.

Several factors could drive up rates next year — including a paucity of younger and healthy enrollees and a greater-than-expected surge in people seeking expensive health services, CEO Patrick Geraghty said in an interview.

Profits for Florida’s HMOs dropped sharply in 2013, with a nearly 31 percent reduction in combined profits, according to the South Florida Business Journal. The Florida Office of Insurance Regulation reported profits at $933.8 million in 2012 and $648 million in 2013.

Update: Late Tuesday, the state Office of Insurance Regulation said information posted about 2015 individual market health insurance rates was incorrect and has been taken off its website. See more.

Something unprecedented may be unfolding in Florida's individual health-insurance market: None of the nine companies that have filed their 2015 rate requests so far wants an increase.

The arrival of insurer-owner emergency centers is catching the attention among those in the hospital industry.

Florida Blue is preparing to open its third GuideWell Health emergency care center in Winter Park, joining other facilities in Largo and Tallahassee, the Orlando Sentinel reports.

Twelve teams of students from eight Florida universities recently faced off at the Second Annual State of Florida Healthcare Innovation Competition to determine whose medical technology reigned supreme -- and the winners walked away with $10,000.

"The competition brings together collegiate healthcare innovators from across the state, and allows them an opportunity to pitch their innovation ideas, concepts, and products before a panel of qualified judges," said Dr. Michael Fountain, director for event co-sponsor, the University of South Florida Center for Entrepreneurship. "In addition to winning cash prizes, these innovations gain insight from these world-class experts to help them move their technologies forward."

A wide variety of products and ideas was pitched, from a Google Glass application for people with cognitive and physical disabilities to a grocery store chain that sells healthy food in low-income neighborhoods.

"I think it speaks, very clearly, to the breadth of what can be done in healthcare innovation, whether it starts out with an application all the way to a small molecule," Fountain added.


Gov. Rick Scott is not backing down from a pair of campaign ads that state 300,000 Floridians lost their Florida Blue health insurance because of the Affordable Care Act, the Miami Herald reports. The ads attack Scott’s presumed opponent, Charlie Crist, for his support of the federal health law, and use a claim about the Floridians losing insurance that was rated “Mostly False” by PolitiFact.

Florida Blue has appointed Dr. René Lerer as president of the state’s largest insurer.

Lerer's will also be president of the GuideWell group. He will report to CEO Pat Geraghty.

Lerer was previously the chairman and CEO of Magellan Health Services. Magellan is a leading national health care management organization or HMO. Earlier in his career he co-founded Internet HealthCare Group, a health care technology venture fund.

He holds a medical degree from the State University of New York at Buffalo and is board-certified in internal medicine.

A new drug hailed as a breakthrough against hepatitis C comes at a price that  puts treatment out of reach for most who need the medication -- $84,000 for a standard 12-week course of Sovaldi, manufactured by Gilead Sciences.

A South Florida health plan ramped up its legal challenge to the state’s decision to award a Medicaid managed-care contract to a competitor, the News Service of Florida reports.

Care Access PSN (for "provider service network") wants the 4th District Court of Appeal to block the state's contract with Prestige Health Choice for patients in Miami-Dade and Monroe counties.

Florida Blue says it is forming its 10th Accountable Care Organization with South Florida’s Memorial  Healthcare System.

Memorial, which treats more than 20,000 patients, includes six hospitals and a network of more than 1,000 primary and specialty care physicians based in Broward and Miami-Dade Counties, the Miami Herald reports. 

Two Florida Blue customers who had been caught in a major glitch in the company’s enrollment process say they received help immediately after WUSF's Health News Florida reported on their problem.

The radio story, which aired Thursday in Tampa Bay on WUSF 89.7 FM during "Morning Edition" and "All Things Considered," was picked up by most other Florida public radio stations the same day or later. Among the stations that aired it was WJCT in Jacksonville, the home base for Florida Blue.

Virtual health care such as mobile apps, telemedicine and electronic records are part of the surge toward more consumer-friendly medicine, health executives tell the Orlando Sentinel. Florida Blue Chairman Pat Geraghty said 2014 marks a major shift in health delivery.

Florida Blue may have bitten off more than it can chew with its new plans under the Affordable Care Act. The company's customer-service apparatus and computer system appear to be overwhelmed and unable to cope.

Already the state’s largest insurer, with more than 1 million covered lives, Florida Blue is offering 76 different health plans through the new federally operated Marketplace. In fact, the company lists more plans by itself than all other insurers put together.

Miami-Dade County, the juiciest plum in Florida Medicaid’s switch to mandatory managed care, could still be in play following a ruling against the Agency for Health Care Administration in its contracting decisions. Hundreds of millions of dollars could ride on the outcome. 

The decision by Administrative Law Judge John Van Laningham, issued Jan. 2 tells AHCA that it should rescind its decision to award a contract to Prestige Health Choice for the region that encompasses Dade and Monroe counties.

A Stuart-based insurance agency that’s the subject of an ongoing state investigation over its “Obamacare Enrollment Team” -- which has no links to any official agency -- is offering donations to nonprofits who help recruit people to sign up for health insurance plans, the Herald/Times Tallahassee Bureau reports.

Jacksonville-based Florida Blue plans to eliminate employer-based insurance plans for 500 early retirees, saying they now can buy private Florida Blue policies or shop on the health insurance exchange.  The move will affect former workers not yet 65, according to the Florida Times-Union.

Orlando Health Physician Partners and Florida Blue have launched an accountable care organization that will include 500 doctors and eight hospitals in Central Florida. An ACO is a new type of Medicare financial arrangement that rewards the doctor-and-hospital network for keeping patients healthy and out of the hospital, rather than rewarding them for filling beds. 

Commercial health insurers could be an alternative to the balky  Healthcare.gov if the White House grants a request from eight Democratic senators, including Florida Sen. Bill Nelson.  If the wish is granted, it could mean a huge influx of new customers for Florida Blue.

A South Florida company that unsuccessfully bid for Medicaid managed care contracts is questioning how a company with financial ties to Florida Blue ended up with contracts in eight of the 11 regions, the Florida Times-Union reports (paywall alert).

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