Florida; A Healthy State: A look back at 5 years of Disease Management in Florida Medicaid

The United States has seen an explosion in health care costs with parallel concerns regarding quality and safety of patient care. With over 90 million Americans living with chronic illness, annual health care spending has topped $1.5 trillion, with nearly 75% of expenditures attributable to chronic disease. Proactive management or prevention of chronic conditions represents the largest opportunity to improve health and contain costs. Disease management (DM), a multidisciplinary system of coordinated interventions emphasizing patient self-management has been shown to be an effective approach to managing chronically ill patients. Florida: A Healthy State (FAHS) was launched in 2001 as a partnership between the State of Florida and Pfizer Health Solutions (PHS) to reduce rapidly growing health care costs by improving the health of chronically ill Medicaid beneficiaries. Together, through a statewide network of community hospitals, civic organizations, consumer and patient advocacy groups and physicians, Florida's Agency for Health Care Administration (AHCA) and PHS designed a program to provide disease management, new health benefits, and support to Medicaid beneficiaries. This new care network empowered participants to change behaviors through coaching, education and personal intervention. Having actively care managed nearly 24,000 of 180,000 beneficiaries who were eligible for the program, significant improvements in behavioral, clinical, and utilization metrics were realized. Leveraging over 5 years of DM experience in the Medicaid market, A HealthierFlorida Florida is launched as another joint effort designed to continue transforming the DM landscape as the state of Florida leads the nation in the next wave of healthcare reform.