Florida health leaders spur discussions on behavioral health reform, value-based care – State of Reform

Four insightful health care leaders offered an on-the-ground look at Florida’s health care system at our 2022 Federal State of Reform Health Policy Conference earlier this month. Highly-discussed topics included behavioral health, community-based care, and moving towards value-based payment models. 

Joining the conversation was Beth Kidder, managing principal at Health Management Associates, Jennifer Sweet, CEO of Aetna Better Health of Florida, Mary Mayhew, CEO of the Florida Hospital Association, and Nathan Landsbaum, CEO of Sunshine Health Florida.

 

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Kidder called attention to the need for more accountability, transparency, and better health outcomes for Florida’s Medicaid program. This is especially key as the Agency for Health Care Administration (AHCA) begins its reprocurement process, which will last for the next six years. Specifically, Kidder highlighted a bill currently moving through the Legislature that would require Medicaid managed care plans to collect data on quality of care consistent with national HEDIS measures.

Additionally, Kidder underscored the importance of a multi-silo effort to assist with the impending Medicaid eligibility redetermination process for over 1.5 million Floridians:

“This is something where I think all stakeholders who have any part in health care will need to be aware of this as this starts to happen. [They need] to assist the state in outreach in getting information to people on Medicaid as to what they need to do.”

Sweet highlighted a number of Aetna’s safety net programs that would focus on social determinants of health and further support vulnerable Floridians. For example, Aetna is in the final stages of establishing a $44 million affordable housing program in one Orlando neighborhood, where 60% of residents are below the poverty line. Aetna is also partnering with community-based organizations on pilot programs that would address chronic conditions such as diabetes and kidney disease.

“By partnering with a [federally-qualified health center], we bring together the strengths of the FQHC and CVS to leverage and promote new access points to the community,” Sweet said.

For Landsbaum, access for behavioral health is one of Florida’s top health priorities and should be integrated into primary care. Within Sunshine health, members and their families have access to a 24/7 crisis hotline, mental health tele-visits, and more. 

“Integrating behavioral health into our overall approach to health isn’t a ‘nice to do,’ it’s a ‘must do’ for improving health outcomes,” he said. 

Mayhew agreed that access to physical and behavioral health is crucial, especially for Medicaid enrollees. However, she said these programs are often siloed into one sector of health care without critical partnerships with other organizations. Additionally, she said current volume-based payment models do not prioritize health outcomes. 

“We know what works, and we’ve got some great [valued-based] models … the challenge is how we take these outcomes and models of care and start driving policy and payment.”


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