5 Things Florida: Medicaid redetermination, COVID-19 treatment costs, Health care workforce

Another week of interim committee meetings kicked off on Monday in preparation for the 2022 legislative session. With session in mind, this edition of “5 Things” features some of the health policy conversations take place and legislation being filed ahead of January 11, 2022.

As always, thanks for reading. If you have story ideas or tips for what we should be covering in Florida’s health sector, we’d love to hear from you!

Emily Boerger
Managing Editor
State of Reform


1. Preparation for Medicaid re-determination

State leaders are preparing for the impending end of the federal public health emergency declaration, which will instigate a lengthy eligibility redetermination process for Floridians who currently benefit from Medicaid. Medicaid enrollment has increased by over 1.2 million members since March 2020, representing a 32.3% jump.

State of Reform caught up with Audrey Brown, president and CEO of the Florida Association of Health Plans, for a conversation on how health plans and the state are preparing for the redetermination period. “The unknown is when that state of emergency at the federal level will be ending. And so for all of our purposes, we just continue the dialogue. We talk regularly with AHCA and the DCF to find out from them if they’ve heard anything new, and I know that the agencies are prepared to reach [the determinations] as quickly as possible.”


2. COVID hospital and treatment costs in FL

FAIR Health recently released a set of interactive maps showing typical costs for COVID-19 treatment and hospitalizations. The data, which evaluates out-of-network and in-network charges, shows Florida with some of the highest rates in the country on some measures.

For COVID-19 complex inpatient treatment, the average out-of-network charge in Florida is over $355,000 – ranking it in the top 10 most expensive states to receive such care. For outpatient COVID treatment, Florida’s average out-of-network charge is $3,172. Just three states have higher costs on this measure. Florida’s profile, which also includes cost data on noncomplex inpatient treatment, is available here.

3. Health committee discusses workforce solutions

Prior to the pandemic, Aurelio Fernandez III, CEO of Memorial Healthcare System, said the system operated at a 13% turnover rate. It’s now on track for a 22% turnover rate. Fernandez offered his perspective and experience at a recent House Health & Human Services Committee meeting focused on health care staffing.

During the meeting, lawmakers discussed the health care workforce challenges facing the state, touching on issues related to inadequate staff pay, the workforce pipeline, and regulatory roadblocks. One solution to the workforce shortage, says Steven Bennett at the Florida Association of Community Health Centers, is the utilization of apprenticeship programs. FACHC is currently building a 15-month apprenticeship program for dental assisting.


4. Lawmakers pre-file over 900 bills

In last month’s newsletter, we highlighted some of the 320 bills that lawmakers had pre-filed before session. That number has since jumped to 911 bills. In this piece, State of Reform Reporter Ethan Kispert features some of the health-related legislation filed in the month of October.

The bills include SB 678, which would cap monthly cost-sharing for insulin, SB 330, which would authorize Medicaid to reimburse providers for certain remote evaluation and patient monitoring services, and SB 544, which aims to reduce overdoses by providing education on emergency opioid antagonists. SB 330 is on today’s Senate Committee on Health Policy meeting agenda.


5. Video: The future of gene therapy

Bhash Parasuraman, vice president of value and access for rare disease and internal medicine at Pfizer, recently joined State of Reform for a conversation on the future of gene therapy. As part of our virtual “Leadership Series,” Parasuraman discussed the policies she’d like to see to support these treatments, barriers to access, and the outlook for the road ahead.

When asked about some of the policymaking that needs to take place to better support gene therapies, Parasuraman said it’s important to look at innovative payment models because unlike most medicines today, gene therapies are one-time treatments. “These are going to be more expensive and that’s going to create some budget challenges, particularly for Medicaid … There needs to be mechanisms or policy changes in place to allow for different payment models.”