Florida Creates Medicaid Plan for Severe Mental Illness

In July 2014, Florida became the first state in the U.S. to create a health plan through Medicaid that is specifically designed for people with serious mental illnesses. Florida hopes that the new program will provide better care for people with serious mental illness while also using the state’s Medicaid funds more efficiently.

Florida has been one of many states that provide mental health care services through subcontractors. This means that mental health patients have to deal with different providers to treat different aspects of their overall health. This process can be confusing for patients as well as physicians, since communication between different providers about individual patients is often flawed. It means that patients are often spending more time and energy to get their various health needs met, while important information is not always communicated among those overseeing their care.

The Importance of Mental Health Coverage

Across the country, mental illness is far more common among people who qualify for Medicaid than among people who do not. Furthermore, Medicaid enrollees with mental illness demand a significant percentage of total Medicaid spending throughout the U.S. Not only can mental illnesses themselves be expensive to treat properly, but people with mental illness are also statistically more likely to have chronic physical conditions that add to the total cost of maintaining their health.

Since mental health treatment affects so many people and costs so much, there is a major incentive for states to figure out a system that is efficient and cost effective. Other states are enacting new programs to provide services to the mentally ill, although only Florida is offering plans specific to those with severe mental illness.

Arizona, for example, is offering people with mental illness the opportunity to get care through separate providers that already share information, to help ensure that important patient-care information is communicated swiftly and fully. Minnesota now requires providers to charge the same fee for physical and behavioral health services, in the hopes that this will limit mental health care costs and help to prevent discrimination against mental health patients.

Physical and Behavioral Health Often Connected

The new Florida Medicaid plan will be offered through Magellan, which was the only company to submit a bid for the mental health plan contract. Florida is already the only U.S. state to offer an HIV-specific plan as well as a plan specifically for children receiving welfare.

Florida believes that its mental health care plan will be the best approach to treating these patients because it provides the best opportunity for integrated care. People with mental illness often struggle to care for not only their everyday physical health, but also to manage chronic physical illnesses like diabetes.

Florida Hopes New Plan Will Save Money

The plan hasn’t officially gone into effect, but Florida is already anticipating it will be a money-saver. It will cost the state a bit more to enroll patients in the mental health plan, since the rate is higher in order to prevent providers from turning away patients with mental health problems. Nevertheless, under the contract with Magellan, the state will pay the provider 5 percent less for mental health services than it would cost to get those services through a contractor who is not part of the Medicaid program.

Florida also hopes that the new plan will ultimately save the state even more money by helping to reduce the need for expensive treatment. If patients can receive consistent and comprehensive care, they should need fewer hospitalizations.