Overview

Since 1999, Florida's Medicaid program has included disease management programs for individuals who are enrolled in MediPass, the Medicaid managed care program that utilizes a primary care case management mechanism. The disease management program targets MediPass patients with HIV/AIDS, hemophilia, diabetes, asthma, cancer, congestive heart failure, kidney disease, hypertension, and several other chronic conditions.

The state estimates that approximately 19 percent of the MediPass population qualifies for disease management services. The state contracts with eight disease management organizations to implement management strategies for each high-cost chronic disease. In 2001, an independent evaluation of the asthma program found a decline in inpatient hospital costs of $70.86 per month; asthma-related outpatient costs decreased $38.06 per month; and total Medicaid expenditures for program participants decreased by 33 percent (approximately $3,525).

Another study found that the program reduced medical claims costs by 38 percent for patients with hemophilia, and 39.7 percent for HIV/AIDS patients, versus previous years' expenditures. Some analysts believe that the main benefit of disease management is not so much cost savings but the improvement of care by providers and administrators, which in turn has lasting effects on health outcomes. As of May 2007, there were 1,199,920 enrollees.

 For More Information

Web site: http://ahca.myflorida.com/Medicaid/MediPass/index.shtml