A PUBLIC LONG-TERM CARE SYSTEM FULLY ADMINISTERED BY PRIVATE FOR-PROFIT HMOS—THE FLORIDA MODEL

摘要

Until 2013 the home and community-based services part of Florida’s public long-term care (LTC) system was administered by the Area Agencies on Aging and non-profit service providers. In 2013, however, most of the publicly funded HCBS programs were folded under HMOs run by large insurance companies such as United Health Care which received contracts to administer all Medicaid funded LTC programs including the nursing home program. This paper includes a description of the political forces at both the state and federal levels that played major roles in the transition to a full scale managed LTC system in Florida, an analysis of the major problems encountered during the transition from both consumer and organizational perspectives, the impact of the new system on costs and quality of care outcomes through 2016, and the impact of MLTC on the Florida Aging Network, in terms of its role(s) in the state’s public LTC system.