WellPoint to Vie for Florida Medicaid Patients

BY CAROL GENTRY, HEALTH NEWS FLORIDA

WellPoint Inc., the nation’s second-largest health insurer, will soon have a major presence in Florida with its purchase of Amerigroup Corp., one of the significant Medicaid contractors in the state.

The Associated Press reported today that Indianapolis-based WellPoint will spend $4.46 billion to acquire AmeriGroup, which has Medicaid contracts with 13 states, including Florida, Texas and New York. Amerigroup is based in Virginia Beach, VA.

Health-industry experts think WellPoint, which has essentially ignored Florida until now, has become interested because of all the low-income government-paid Medicare/Medicaid patients who will be moving into managed care.

“It’s a sign of some of the changes we’re going to see in the market as we transition to Medicaid managed care,” said Michael Garner, president of the Florida Association of Health Plans. “It’s going to attract companies that have not traditionally operated in Florida.”

Medicaid, a joint state and federal program for the poor and disabled, moved into managed-care contracts in Florida years ago. But most of those who signed up are the beneficiaries who cost relatively little: children and pregnant women.

The high-cost Medicaid patients are the frail elderly who qualify for nursing homes and the physically or mentally disabled who have little income. These “dual eligibles,” so called because they qualify for both Medicare and Medicaid, offer companies high monthly premiums and thus tantalizing profits if they can keep them relatively healthy and out of institutions.

Florida’s Legislature voted in 2011 to move the dual eligibles into managed care beginning next year; the state has applied for a waiver of federal Medicaid rules to make the move possible. Florida’s Medicaid program is managed by the Agency for Health Care Administration.

On June 29, AHCA announced it had begun issuing invitations to negotiate for the Long-term Care Managed Care component of the Statewide Medicaid Managed Care program. Companies have until Aug. 28 to respond; more information is available at this website.

AHCA official Beth Kidder told an audience of health consultants late last month that her agency has been so busy getting the invitation to negotiate ready they’ve had no time to issue updates on the likelihood of obtaining the federal go-ahead to expand Medicaid managed-care statewide. She said Florida officials have been given assurance they will receive the waiver.

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