Transcript Document

Florida Department of Health
Low Income Pool
Primary Care/Hospital Diversion Projects
Florida Hospital Association Readmission Webinar
February 18, 2010
1
Low Income Pool
 $1 billion Medicaid Reform program
 94% of pool distributed to hospitals
2
LIP Council

24 members
Provides pool $ distribution
recommendations to Legislature
3
LIP “Non-hospital Projects”
$51.3 million for current state fiscal year
$3.2 mil – Poison Control
$18.3 mil – FQHCs
$16.1 mil – Premium Assistance
$1.2 mil – ER Diversion
$3.0 mil – Hospital Primary Care
$9.5 mil – DOH Primary Care/Diversion
4
LIP Primary Care Funding History
SFY 2006-07 - $2.0 mil
6 projects
SFY 2007-08 - $3.0 mil
7 projects
SFY 2008-09 - $6.5 mil
11 projects
SFY 2009-10 - $9.5 mil
13 projects
5
6
Project Goals
 ED Diversion
 Primary Care Medical Home
 Chronic Disease Management Services
 Link uninsured persons to health coverage
7
Project Components
Hospital based navigators or formal referral
arrangements with hospitals
Expanded primary care clinic capacity and operating
hours
Trained chronic disease management case managers
and educators
8
Project Components
Pharmacy assistance services
Linkages to specialists through We Care Networks or
other volunteer provider organizations
Eligibility assistance staff
9
Project Statewide Summary Statistics
January 1, 2009 through June 30, 2009
Emergency Room Diversions
5,683
Emergency Room and Hospital
Referrals
5,593
LIP Patients Provided with a
Medical Home
11,415
LIP Patients Enrolled in Disease
Management Programs
2,259
10
Key Project Successes
High proportion of LIP project referrals are enrolled
in a primary care medical home and return for
subsequent health care services
Patients have much improved access to needed
and appropriate health care services
Significant expansion of disease management
capacity and improved health status of enrollees
Excellent utilization of pharmacy assistance
programs that help reduce hospital re-admissions
11
Project Challenges
Meeting the need for basic clinical primary care –
demand is greatly challenging supply
Providing timely access to specialty services
Complexity of the chronic disease clients
Transient nature of the targeted population
12
Project Challenges
Educating the target population on the concept of a
primary care medical home
Hiring physicians and nurses at state pay scales
Partnerships can be a double-edged sword – usually a
great asset but sometimes a liability
13
To Where from Here?
Recommend expansion of primary care/disease
management projects
Develop more direct partnerships with hospitals
Use primary care/chronic disease management
programs to help reduce hospital readmissions
14
Questions?
15