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Group Title: Evaluation of the Florida Medicaid MediPass program
Title: Addendum
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Title: Addendum
Series Title: Evaluation of the Florida Medicaid MediPass program
Physical Description: Book
Language: English
Creator: Florida Center for Medicaid Issues, College of Health Professions, University of Florida
Publisher: Florida Center for Medicaid Issues, College of Health Professions, University of Florida
Place of Publication: Gainesville, Fla.
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Volume ID: VID00002
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    MCO options by county
        Page 18
        Page 19
        Page 20
    Results for all survey items
        Page 21
        Page 22
        Page 23
        Page 24
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        Page 31
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        Page 33
        Page 34
        Page 35
    MCO enrollment reports
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
    Hispanic enrollment by county
        Page 46
        Page 47
Full Text

















Evaluation of the Florida Medicaid MediPass Program
Addendum Reweighted Results











Florida Center for Medicaid Issues


Heather Steingraber
Eleni Dimoulas
Renee Dubault
Robert G. Frank, Ph.D.


For the Period Ending June, 2002







Introduction


This report is an addendum to the Report submitted by the Florida
Center for Medicaid Issues in January, 2002, titled Evaluation of the
Florida Medicaid MediPass Program. This document presents re-
weighted and re-analyzed data gathered for that report.
Demographics and program satisfaction are reported for adult
Medicaid enrollees, and are presented showing results for respondents
overall, as well as by the type of Managed Care Organization of the
respondent. For those enrolled in the MediPass program, data are also
presented broken down by whether the respondents resided in a
county with offers HMOs or in a county which offers only MediPass.


Purpose


Medicaid Managed
Care Organizations


The purpose of this report addendum is to examine the demographic
characteristics of MediPass enrollees, as compared with the
characteristics of HMO enrollees, and to assess the satisfaction of
MediPass enrollees in comparison to HMO enrollees. Furthermore, the
report aims to determine if there are differences in demographics and
satisfaction between MediPass enrollees who reside in counties which
offer HMOs and those who live in counties which do not offer HMOs.
The previous MediPass evaluation report presented similar data, though
they were not examined in detail, nor were the results weighted to
account for market share.


The Agency for Health Care Administration (AHCA) has contracted
with various Managed Care Organizations (MCOs) to oversee the
health care of Medicaid enrollees. Two types of MCOs are currently
available for adults in the Florida Medicaid program:' Health
Maintenance Organizations (HMOs), and the Medicaid Provider
Access System (MediPass). The HMOs and the MediPass program offer
benefits packages that are substantially similar, though the HMOs may
offer special services such as transportation to medical appointments,
and over-the-counter drug reimbursement, in addition. The two types
of MCOs differ in how they manage the care of their enrollees and in
how they manage the providers in their network. Further information on
the differences between MCOs can be found in the Florida Medicaid
Summary of Services. As of December, 2001, Medicaid HMOs were
available in 44 of the 67 Florida counties, and many counties (32)
offered more than one HMO to their enrollees (see Appendix A). All
counties offer the MediPass program.

Upon enrollment, those who reside in counties without HMOs are
automatically enrolled in MediPass, while thosewho reside in counties
with HMOs must choose from among the managed care options
offered in their county. If an enrollee fails to indicate his or her choice
to Medicaid within 30 days of the date Medicaid eligibility began, he or
she is assigned to one of the MCOs by AHCA.


i A third managed care option, the Provider Service Network (PSN), is also available on a trial basis for residents of Dade and Broward
Counties. Because the PSN is a pilot project and is available on such a limited basis, it is not included in these analyses.
Page 1







Methodology


In order to gather demographic information from HMO and MediPass
recipients, and to assess relative satisfaction with the different MCOs,
program enrollees were telephoned in their homes and asked to
complete a short questionnaire. The Consumer Assessment of Health
Plans Survey (CAHPS) version 2.0 was administered to those who
consented to participate. The CAHPS is a standardized survey
instrument, used widely in the health care industry to assess enrollee
satisfaction with health plans. Demographic questions are also
included as part of the CAHPS.


Sampling


Survey Administration


Outcome Rates


Concurrent, random samples were drawn from among HMO
enrollees and MediPass enrollees. The HMO sample was chosen as
part of AHCA's HMO Report Card project, and the survey results for
that project were used for comparison with the MediPass surveys
conducted for this project. Information concerning the sampling
procedures or response rates for the HMO surveys can be found in the
Florida HMO Report 2002.

The MediPass sample was drawn from among program enrollees who
had been continuously enrolled in MediPass for 6 or more months.
The sample was stratified according to whether the enrollees resided
in a county which offered HMOs or in a county which did not offer
HMOs. These strata were then treated as separate samples. Survey
dispositions and completed interviews were tracked separately for
each sample.


The Survey Research Center at the University of Florida's Bureau of
Economic and Business Research conducted 904 surveys between
the months of January and April. The quality of the contact
information for enrollees was poor, with nearly 47% of the sample
having no telephone number on file, and a further 36% having a
phone number that proved to be incorrect or disconnected. The
samples were sent to a commercial organization which provides
contact information for telephone marketers and researchers, but the
database match yielded only 33% matches, many of which proved
to be for the same erroneous number that was in the sample file.
Recipients were contacted up to 25 times in an attempt to secure
cooperation or obtain updated contact information.


An important aspect in determining whether survey results are truly
representative of the population in question is to determine whether
"non-response effects" exist. Non-response effects occur when non
respondents from the original sample differ from those who did
respond in significant ways which might affect results of the study.
One important step in determining whether non-response effects exist
is to calculate outcome rates.


Page 2








The American Association for Public Opinion Research (AAPOR)
recognizes the use of a number of different types of outcome rates,
and a number of different methods for calculating each of those
types2. One type of outcome rate is the Response Rate, which takes
into account the number of interviews in proportion to the number of
eligible respondents. Numerous methods exist to calculate Response
Rates, with major differences being in the way in which the number of
eligibles is determined and the way partial interviews are allocated.
Another type of outcome rate is the Cooperation Rate, which takes
into consideration the number of interviews in proportion to all eligibles
ever contacted. Cooperation Rates exclude from calculation those
respondents who could not be located. Like Response Rates, there are
numerous ways to calculate Cooperation Rates, with the major
differences being in the way that the number of eligibles is determined
and the way partial interviews are allocated. Researchers consider
various criteria in determining which outcome method to use, with the
quality of the sample being a major criterion in their decision.

Table 1 below shows response rates and cooperation rates for the
MediPass surveys, calculated using four different AAPOR-approved
methods. Response Rate (RR) 1 is the most stringent method given,
and RR6 is the least restrictive of the response rate methods.
Cooperation Rate (COOP) 1 is less stringent than either RR method, and
COOP4 is the least stringent of all methods presented. Despite the
steps taken to increase participation in the surveys, the outcome rates
were less than optimal, though acceptable, given the quality of the
sample. The outcome rates ranged from a high of 89% to a low of 23%,
depending on which method was used.


Table 1. Outcome Rates
Number of Number in More Stringent-> Less Stringent
Completed Entire Resp. Rate 1 Resp. Rate 6 Coop. Rate 1 Coop. Rate 4
Interviews Sample
Enrollees in Counties 392 1,693 23.18% 64.79% 70.38% 88.88%
with HMOs
Enrollees in Counties 512 1,790 28.60% 66.15% 76.88% 88.73%
without HMOs


Data Analysis and The HMO and MediPass samples were analyzed concurrently using SAS.
Weighting Descriptive statistics were calculated for both samples and selected
results are discussed in this report. All statistics are reported in Appendix
B.

The survey data set for the HMO respondents was weighted to reflect
the actual distribution of individual HMO enrollment in Florida Medicaid.
The reports of each HMO's respondents were weighted according to
the actual market share that particular HMO occupied within the
Medicaid program as of December, 2001. The reason for this weighting


2 The American Association for Public Opinion Research. 2000. Standard Definitions: Final Dispositions of Case Codes and Outcome Rates
for Surveys. Ann Arbor, Michigan: AAPOR
Page3


























Report Organization


is to properly reflect the relative sizes of each HMO; companies with
large enrollments should have a larger "impact" on results than those
with smaller enrollments. Appendix C shows the actual enrollment for
each Medicaid HMO, which were used to calculate the weights.

The MediPass data were also weighted according to the actual
proportion of enrollees who reside in counties which offer a choice
between MediPass and HMO, and those counties which do not offer
choice. These enrollment figures and corresponding weights can also
be found in Appendix C.

The overall Medicaid figures which are reported are also weighted,
according to the overall proportion that each groups (each of the 32
HMOs, MediPass enrollees in counties with HMOs, MediPass enrollees in
counties without HMOs) represents in the Medicaid population.


As mentioned previously, results for each item in the CAHPS survey can
be seen in Appendix B. Selected results are also discussed in the body
of this report. First, results for Medicaid enrollees overall are discussed,
and differences between the ratings of MediPass respondents and
HMO respondents are explored. In a subsequent section, the
differences between the ratings of enrollees in HMO counties and in
MediPass-only counties are explored. Finally, recommendations are
given for future research.


Page 4







HMO vs. MediPass

Demographics The demographic characteristics of the HMO respondents and
Medicaid respondents are discussed below.

Gender Overall, 75% of respondents were female, while 25% were male. The
HMO group contained a significantly smaller portion of males than
the MediPass group (p<.0001), with 22% of HMO respondents being
male, as compared to 28% of the MediPass group.

Age The mean age of all respondents was 44.87 0.25 years. HMO
enrollees were slightly younger than MediPass enrollees, with means
of 44.14 0.48 years for HMO enrollees and 45.240.28 years for
MediPass enrollees. Although this difference in ages was statistically
significant (p<.018), it is so small as to be practically meaningless.

Race Overall, 57% of Medicaid enrollees responding to this survey were
white only3, while 34% were black only, and less than 9% were Asian or
of another or mixed race. There was a statistically significant
difference between the racial composition of the HMO group versus
the MediPass group, with HMOs having a significantly larger portion of
blacks and a smaller portion of whites than MediPass. Figure 1 shows
the racial distribution among the two programs. Fifty-five percent of
HMO enrollees were white, compared with 66% of MediPass enrollees.
Forty-one percent of HMO enrollees were black, compared with 30%
of MediPass enrollees. These differences were statistically significant
at the p<.0001 level.

Figure 1. Racial Characteristics of MediPass and HMO Enrollees


Page 5


70%
60%-
50%
40%-
30%-
20%
10%
0%
HMO MediPass

U White E Black O Other


3 Race figures reported here for Whites and Blacks include respondents who reported being only White, or only Black. Respondents who
reported being of more than one racial background, or of Asian or some other single race, were included in the "Other" category, due
to the small numbers in these categories. The figures in Appendix B show the portions in each category, without exclusion due to
multiple categories.






Ethnicity




Education


Health Status


Among Medicaid respondents as a whole, 20% reported that they
were of Hispanic ancestry, while 80% reported that they were not.
There was no statistically significant difference between the ethnic
characteristics of MediPass enrollees and HMO enrollees.

Overall, 40% of Medicaid respondents reported that they had less
than a high school degree, while 36% reported having finished high
school or obtained a GED, and 25% reported having education
beyond high school. As compared with MediPass enrollees, the HMO
enrollees were slightly less educated. Table 2 shows the education
levels reported by respondents in each group. The differences in
education levels between the two programs was statistically
significant (p=.0097).

Table 2. Highest Level of Education Attained Among HMO and
MediPass Enrollees

HMO MediPass
Less than High School 41% 38%
High School Graduate/GED 36% 36%
Beyond High School 24% 27%

Roughly half (53%) of Medicaid respondents reported being in "fair"
or "good" health, while 20% reported being in "poor" health, and the
remaining 28% reported being in "very good" or "excellent" health. A
significantly larger portion of HMO enrollees reported being in poorer
health as compared with MediPass enrollees. (See Table 3.) The
difference in health status between the programs was statistically
significant, with p<.0001.

Table 3. Self-Reported Health Status Among Medicaid Enrollees


HMO MediPass
Excellent 6% 11%
Very Good 7% 17%
Good 25% 24%
Fair 30% 25%
Poor 18% 23%


Satisfaction




Continuity of Care Upon
Enrollment


Overall, Medicaid enrollees are very satisfied with the quality of care
they receive, regardless of whether they are enrolled in an HMO or in
MediPass. Selected measures of satisfaction and quality of care from
the CAHPS 2.0 are discussed below.

The term "Continuity of Care" refers to the extent to which enrollees
are able to see a single health care provider over a period of time.
Measuring the continuity of care that enrollees receive is an
important step in describing the overall quality of care provided by a
health insurance program like Medicaid. To this end, subjects were
asked whether they had continued to see the same health care
provider while on Medicaid as they had seen before enrolling, and


Page 6







whether they had switched providers since then. Fifty-six percent
indicated that they had gotten a primary care provider (PCP) upon
enrollment or at some point since then. HMO enrollees reported
significantly poorer continuity of care as compared with MediPass
enrollees. Forty-eight percent of HMO enrollees reported that they
had changed PCPs at some point since enrolling in Medicaid, while
40% of MediPass enrollees changed providers. (see Figure 2) This
difference was statistically significant, with p>.0001.




Figure 2. Continuity of Care

HMO MediPass


* Received New Doctor
D Did Not Receive New Doctor


M Received New Doctor
i Did Not Receive New Doctor


Usual Source of Care


Among those who had changed primary care providers while
enrolled, 69% of Medicaid enrollees overall reported that it was "not a
problem" to find a satisfactory PCP while on the program, and the
reports of the HMO and MediPass groups did not differ significantly

The majority of Medicaid enrollees (77%) reported having a primary
care provider (called a "personal doctor or nurse" in the CAHPS) at
the time of interview. Significantly fewer HMO enrollees reported
having a PCP, however, compared to the MediPass enrollees.
Seventy-four percent of HMO enrollees reported having a PCP, while
80% of MediPass enrollees had a PCP. This difference between the
programs was statistically significant (p<.0001).

Those who reported that they had a primary care provider were
asked to rate this provider on a scale of 0 to 10, with 0 being the
"worst personal doctor or nurse possible," and 10 being the "best
personal doctor or nurse possible." Medicaid enrollees overall rated
their PCPs highly, with a mean score of 8.66 0.03. HMO enrollees
rated their providers slightly lower than MediPass enrollees, with a
mean rating of 8.60 0.04 for HMO enrollees, and 8.76 0.07 for
MediPass enrollees. This difference in ratings was statistically
significant (p<.015).


Page 7







Care from Specialists


Calling Providers' Offices


Approximately 41% of Medicaid enrollees overall reported that they
had needed to see a specialist physician at some time in the 6
months prior to survey. Roughly two-thirds of those who needed to
see a specialist reported that it was "not a problem" to get a referral
for this care, while 12% reported it was "a small problem" and 21%
reported it was "a big problem." These figures did not differ
significantly between the HMO and MediPass groups.

Among those who reported that they or their PCP thought they
needed to see a specialist, 41% reported actually having seen a
specialist. Forty percent of HMO enrollees reported getting the
needed specialty care, while a slightly higher percentage (42%) of
MediPass enrollees reported thus. This difference was not statistically
significant.

While it is disturbing that less than half of Medicaid enrollees got the
specialty care they needed, it is important to remember that these
enrollees were not asked why they did not get this care. It is possible
that they got a referral, but never made the appointment, or that
they had an appointment but missed it. The respondent could have
had transportation problems or had no specialty providers in their
area. It is also important to remember that the CAHPS question asks
whether "they [the respondent] or a doctor" thought they needed
specialty care. In some cases, it could be that the individual felt that
he or she needed specialty care, but did not consult his or her
primary care physician to seek a referral.

When asked to rate their specialist on a scale from 0 to 10, Medicaid
enrollees overall gave a mean rating of 8.59 0.05. The ratings of
HMO enrollees and MediPass enrollees were virtually identical, at 8.52
0.06 and 8.62 0.12, respectively.

Forty-nine percent of Medicaid enrollees reported that they had
called their PCP's office to get help or advice during the 6 months
prior to interview. This figure did not vary significantly between HMO
enrollees and MediPass enrollees. When asked whether they
received the help or advice needed as a result of this call, 75% of
enrollees reported that they "usually" or "always" received the help
needed, while 25% reported that they "sometimes" or "never" got
that help. When compared with MediPass enrollees, HMO enrollees
were significantly more likely to report having problems getting the
help they needed (Table 4). The differences between the reports of
HMO and MediPass enrollees were significant, with p<.004.

Table 4. How Often Enrollees Reported Getting the Help and Advice
They Needed when Calling a Primary Care Provider's Office


HMO MediPass
Always 57% 58%
Usually 16% 19%
Sometimes 21% 15%
Never 6% 8%

Page 8






Appointments for Routine
Care















Appointments for Acute
Care











Overall Medical Care


Overall, 64% of Medicaid enrollees reported that they had made an
appointment for regular or routine health care in the 6 months prior to
interview. HMO enrollees were significantly more likely to report
having made an appointment when compared with MediPass
enrollees. Sixty-five percent of HMO enrollees had made an
appointment for routine care, while 62% of MediPass enrollees
reported having done so. This difference was statistically significant
(p<.0032). Among those who had made an appointment, 63%
reported that they "always" got the appointment as soon as they
wanted. An additional 17% reported that they "usually" got the
appointment as soon as they wanted, while 16% reported
"sometimes" and 4% reported "never." There was no statistically
significant difference between the report of the HMO enrollees versus
the MediPass enrollees on this measure.

When asked whether they had had an illness or injury needing
immediate care in the 6 months prior to interview, 43% of Medicaid
enrollees surveyed reported affirmatively, and there was no
difference between the reports of the HMO and MediPass enrollees.
Those who had an illness or injury needing immediate care were
asked whether they had gotten that care as soon as they wanted.
Sixty-four percent reported that they "always" got this care as soon as
needed, while 14% reported that they "usually" got it, 17%
"sometimes" got it, and 6% "never" got the care as soon as they
wanted it. These figures were similar for HMO and MediPass enrollees.

Medicaid enrollees were asked about their overall health care from
all sources. Subjects reported having sought care an average of 3.66
0.03 times overall in the 6 months prior to interview. HMO enrollees
reported slightly more doctor visits, at 3.59 0.03, compared with
MediPass enrollees, at 3.73 0.07 (p=.0275). HMO enrollees reported
having trouble getting care significantly more frequently (p=.0015)
than MediPass enrollees, though a large majority in both groups (70%
in HMO and 75% in MediPass) reported it was "not a problem." (see
Figure 4.)


Figure 4. Enrollees' Experiences Obtaining Medical Care


Problems Getting Necessary Care


Not a A Small A Big
Problem Problem Problem

I HMO E MediPassI


Problems with Delays in Health Care

80%
70%
60%


30%
20%
10%
0%
Not a A Small A Big
Problem Problem Problem

I HMO E MediPass


80%-
70%-
60%-
50%-
40%-
30%-
20%-
10%-
0%-


Page 9


1

















Long Office Wait Times for
Primary Care


Providers' Office Staff


HMO enrollees were significantly more likely (p<.0001) than
MediPass enrollees to report having experienced delays in
getting health care while waiting for plan approval. Again,
however, only a minority reported having experienced any
problems. Seventy percent of HMO enrollees reported that
delays in health care were "not a problem," while 77% of
MediPass enrollees reported no problems with delays. (see
Figure 4.)

Many Medicaid enrollees (40%) reported that they frequently
experienced long wait times in their primary care providers'
office. HMO enrollees waited more than 15 minutes past their
appointment time significantly less frequently than MediPass
enrollees. Thirty-six percent of HMO enrollees reported that
they "usually" or "always" experienced long wait times, while
43% of MediPass enrollees reported waiting. This difference
between programs was statistically significant at the p<.0001
level.

Figure 5. Frequency of Experiencing Long Office Wait
Times for Primary Care


40%
35%
30%
25%
20%
15%-
10%
5%
0%
Never Sometimes Usually Always

HMO E MediPass



Medicaid enrollees were asked about whether their PCP's
office staff were courteous, and whether the staff were helpful.
Overall, 79% of respondents indicated that the staff was
"always" courteous and respectful, and 65% reported that
they were "always" helpful. There were small, but statistically
significant differences in the reports of HMO enrollees and
MediPass enrollees on these measures (p=.0003, p=.0029,
respectively) with HMO enrollees reporting that staff were
courteous and helpful slightly less frequently than MediPass
enrollees (See Table 4).


Page 10

























Communicating with Providers













Provider Shows Respect












Provider Spends Time







Overall Health Care Rating


Table 5. Courteousness and Helpful of Providers' Office Staff
HMO MediPass
Primary Care Providers' Staff Were
Courteous and Respectful
Never 4% 2%
Sometimes 8% 9%
Usually 9% 10%
Always 79% 79%
PCP's Staff Were Helpful
Never 4% 2%
Sometimes 17% 15%
Usually 16% 15%
Always 63% 68%


Medicaid enrollees indicated that they had little trouble
communicating with their health care providers. Seventy
percent of Medicaid enrollees overall indicated that they
"always" felt that their PCP listened carefully to them, and
71% indicated that their provider "always" explained things
to them in a way they could understand. Seventy-six percent
of enrollees reported that they did not have problems
communicating with their providers due to language
differences. There were statistically significant differences in
the reports of HMO and MediPass enrollees on these
measures, though the differences were so small as to be of
no practical value.

The majority of Medicaid enrollees indicated that their PCP
showed respect for their opinions, with 71% indicating that
their provider "always" showed respect. There were slight
differences in the reports of HMO enrollees and MediPass
enrollees, with HMO enrollees being slightly less likely than
MediPass enrollees to report that their provider showed
respect. Sixty-nine percent of HMO enrollees reported that
their PCP "always" showed respect for their opinions,
compared with 73% among MediPass enrollees. These
differences in perceived respect from providers are small, yet
statistically significant (p<.0001).

The majority of both HMO enrollees and MediPass enrollees
reported that their PCPs spent enough time with them.
However, a slightly smaller percentage of HMO enrollees
reported that their PCPs "always" spent enough time with
them as compared with the MediPass enrollees, with figures
of 61% and 65%, respectively. This difference was statistically
significant (p=.0106).

Medicaid enrollees rated their health care very highly, with a
mean rating of 8.37 0.04. HMO enrollees rated their care


Page 11













Interpreter Services







Information from the Plan


Customer Service


slightly less favorably than MediPass enrollees, with a mean
rating of 8.24 0.04 for HMO enrollees and 8.51 0.08 for
MediPass enrollees. This difference in ratings between the
programs was statistically significant (p=.0002).

The vast majority of Medicaid enrollees surveyed, (95%)
indicated that they did not need an interpreter to help them
communicate with their doctor or other health provider.
Among those who did need an interpreter, slightly less than
half indicated that they "usually" or "always" got that help
when needed. There were no differences in the reports of
HMO and MediPass enrollees on these measures.

Most Medicaid enrollees indicated that they received
information from their plan when they enrolled. A higher
percentage of HMO enrollees reported having received
information as compared with MediPass enrollees (73% and
68%, respectively, with p=.001 7). It is important to remember,
however, that the CAHPS survey item does not make clear
whether the information received was general information
from Medicaid, or whether it was from the specific MCO that
was chosen. There was a statistically significant difference
(p=.0009) between the reports of HMO and MediPass
enrollees on whether the information received was correct.
Sixty percent of HMO enrollees reported that "all" of the
information given was correct, while 66% of MediPass
enrollees reported that it was "all" correct.

Most enrollees reported that they did not look for any written
materials from their program. Large differences were found
on this measure between HMO and MediPass enrollees, with
more HMO enrollees reporting that they looked for the
materials than MediPass enrollees. Thirty-seven percent of
HMO enrollees reported that they looked for written materials
from the program, while 18% of MediPass enrollees looked for
materials. This difference is statistically significant, with
p<.0001. Those who did look for written information largely
reported that they had no problems finding or understanding
the materials.

When asked whether they had called the program's
customer service department, 46% of HMO enrollees
reported affirmatively, while 22% of MediPass enrollees
reported that they had called. This difference was
statistically significant at the p<.0001 level. There was also a
difference between the programs in terms of the quality of
the customer service help received (p=.01 67). Fifty-seven
percent of HMO enrollees reported that it was "not a
problem" to get the help they needed, compared with 50%
of MediPass enrollees. (See Figure 6.)


Page 12







Figure 6. Experiences with Getting Help from Customer
Service


Paperwork


As compared with MediPass enrollees, more HMO enrollees
reported that they had experienced having to do paperwork in
their plan. Seventeen percent of HMO enrollees reported
having done paperwork, compared with 14% of MediPass
enrollees (p=.0043) Among those who did do paperwork, a
larger percentage of HMO enrollees reported having
experienced problems with this paperwork, as compared with
MediPass enrollees (p=.0037).


Figure 7. Experiences with Paperwork


Overall Plan Rating


Medicaid enrollees overall rated their health plan 8.11
0.04 on a scale of 0 to 10. The ratings of HMO enrollees
and MediPass enrollees were significantly different


Page 13


60%
50%
40%
30%
20%
10%
0%


No ASal i


A Small
Problem


I HMO MediPass


70%"
60%
50%-'
40%"
30%"
20%"
10%-
0%
Not a A Small A Big
Problem Problem Problem

U HMO U MediPass


Not a
Problem


A Big
Problem













Section Summary


(p=.0064), with HMO enrollees rating their plan slightly lower
than MediPass enrollees. The mean HMO rating was 8.01
0.04, while the mean MediPass rating was 8.21 0.08.


The HMO and MediPass groups were significantly different in
terms of health status, education and race. HMO respondents
were less educated and less healthy than their MediPass
counterparts, and a larger portion of them were black.
Demographic differences such as these have been shown to
affect program satisfaction in other studies. However, the
interaction of these characteristics and their effect on
satisfaction are beyond the scope of this report.


While most Medicaid enrollees are satisfied with their care,
MediPass enrollees were more satisfied than HMO enrollees on
a number of measures. On all four measures of overall
satisfaction, the MediPass respondents ranked their plan more
favorably than the HMO respondents. (See Figure 7.) For
many of the items that measured satisfaction with providers,
(e.g., PCP explained things clearly, showed respect for patient,
spent time with patient) the differences were small. On items
related to the health plan itself, (e.g., problems with
paperwork, program information being correct) the
differences were larger. The HMO enrollees reported
significantly more favorably than MediPass enrollees on two
measures: waiting times in doctor's offices and getting help
from customer service.

Figure 7. Health Plan Ratinas


8.80-

8.60-

Scale: 8.40-
0to 10 8.20-

8.00-

7.80-

7.60
PCP Specialist Overall
Health Car

HMO E MediPass


Overall
e Health Plan


Page 14


=







MediPass Counties With HMOs vs. Counties Without HMOs


Demographics


The demographic characteristics of enrollees in counties which
offer Medicaid HMOs did not vary significantly from counties
which did not offer HMOs in terms of health status, age,
gender, education level, or race. They did vary, however, in
terms of ethnicity, with a larger percentage of the HMO county
group being Hispanic than is found among non-HMO county
group. Twenty-four percent of the HMO county group was
Hispanic, while 7% of the non-HMO county group was Hispanic,
with the difference being statistically significant at the p<.0001
level. This finding is, perhaps, not surprising, considering that
95% of Hispanic enrollees reside in counties which offer HMOs4.

Figure 8. Ethnicity of Medicaid Enrollees Residing in HMO
Counties and non-HMO Counties


Residents of HMO Counties


Im Hispanic M Non Hispanic


Residents of Non HMO Counties


I Hispanic M Non Hispanic


Satisfaction


For the vast majority of questionnaire items relating to
satisfaction, the reports of MediPass enrollees living in HMO
counties did not differ significantly from those of enrollees
living in non-HMO counties. Exceptions are discussed below.

As expected, the reports of residents of HMO counties and
non-HMO counties differed significantly when asked whether
they chose their plan or were assigned to it. Significantly
more residents of HMO counties indicated that they chose
their plan, as compared to residents of non-HMO counties,
with figures of 53% and 37% respectively. This difference is
significant at the p=.0004 level. Residents of non-HMO
counties were not in fact offered any choice of plan, since
only the MediPass program is offered in their county.

When asked about whether they had received information
about the program before becoming enrolled, significantly
fewer residents of HMO counties reported that they had
received information as compared with residents of non
HMO counties. Sixty-six percent of HMO county respondents


4Data from an analysis of Medicaid enrollment files.


See Appendix D for Hispanic enrollment by county.


Page 15







indicated that they had received information, while 76% of
non-HMO counties indicated having received information
(p=0.0181).


Section Summary Residents of HMO counties and non HMO counties did not
differ significantly on any of the CAHPS 10-point scales.

In terms of gender, race, age, health status, and education
level, there is no statistically significant difference between
MediPass enrollees living in counties with HMOs and those living
in counties without HMOs. However, there is a difference in
terms of ethnicity, with a higher percentage of Hispanics
residing in HMO counties as compared with the number
residing in non-HMO counties.

By and large, satisfaction did not differ significantly between
the HMO counties and non-HMO counties.


Page 16







Recommendations


Future evaluations of the MediPass program may wish to address
the following issues in detail:

Determine whether enrollees who choose their MCO are
different in terms of demographics or satisfaction from
those who are assigned to their program because they
fail to submit their choice within 30 days of the date of
eligibility.

Analyze whether satisfaction varies with use of health
care services.

Determine whether those with poorer self-reported health
status are less satisfied with their health care, and if so,
explore the reasons why this is the case. Previous
research has suggested that those with special health
care needs are less satisfied, possibly because their health
conditions requires greater care and more resources than
most. These findings have not been explored among
Florida's adult Medicaid population.

Determine whether rates of referrals for specialty care
differ between HMO enrollees and MediPass enrollees,
taking into consideration the case-mix of the patients.
This issue could be explored in a variety of ways, including
an examination of medical records, an analysis of
medicaid claims and encounter data, a survey of
patients, and a survey of providers.


Page 17












Appendix A: MCO Options by County





Source: AHCA and DOI Websites







MCO Choices by County


Counties with HMOs Counties without HMOs
(number of HMOs in parentheses,
if more than one)
Alachua X
Baker X (2)
Bay X
Bradford X
Brevard X (3)
Broward X (10)
Calhoun X
Charlotte X
Citrus X (2)
Clay X (2)
Collier X
Columbia X
De Soto X
Dixie X (2)
Duval X (2)
Escambia X (2)
Flagler X
Franklin X
Gadsden X (3)
Gilchrist X
Glades X
Gulf X
Hamilton X
Hardee X
Hendry X
Hernando X
Highlands X (3)
Hillsborough X (5)
Holmes X
Indian River X
Jackson X
Jefferson X (3)
Lafayette X
Lake X (3)
Lee X (4)
Leon X (3)
Levy X
Liberty X
Madison X (3)
Manatee X (4)
Marion X (2)
Martin X (2)
Miami-Dade X (12)
Monroe X
Nassau X
Okaloosa X
Okeechobee X
Orange X (6)
Osceola X (5)







MCO Choices by County


Counties with HMOs Counties without HMOs
(number of HMOs in parentheses,
if more than one)
Palm Beach X (8)
Pasco X (5)
Pinellas X (5)
Polk X (6)
Putnam X (2)
Santa Rosa X (2)
Sarasota X (4)
Seminole X (5)
St. Johns X
St. Lucie X
Sumter X
Suwannee X
Taylor X
Union X
Volusia X (3)
Wakulla X (3)
Walton X
Washington X










Appendix B:


Results for All Survey Items







Demographic Characteristics of Survey Respondents: HMO vs. MediPass (weighted)



Medicaid Overall HMO MediPass Tests of Significance

N %ors N %ors N %ors 2 or t P
Self-Assessed Overall Health
Excellent 545 12 287 6 258 11
Very Good 738 16 335 7 403 17
Good 1130 25 584 25 546 24 33.35 <0.0001
Fair 1257 28 681 30 576 25
Poor 937 20 408 18 529 23

Mean Age 44.87 0.25 44.14 0.48 45.24 0.28 2.37 0.018

Sex
Male 1162 25 517 22 645 28
17.87 <0.0001
Female 3506 75 1810 78 1695 72

Highest School Grade Completed
8th Grade or Less 665 15 329 14 336 15
Some High School, but Didn't Graduate 1138 25 608 27 530 23
High School Graduate, or GED 1642 36 821 36 821 36
15.16 0.0097
Some College or 864 19 407 18 457 20
2-Year College Degree 184 4 89 4 96 4
4-Year College Degree or More 93 2 34 2 59 3

Hispanic or Latino Origin or Descent
Yes 922 20 449 20 473 21
0.4 0.5274
No 3650 80 1820 80 1830 79

Race
White 2676 57 1222 53 1454 62 44.02 <0.0001
Black or African-American 1569 34 907 39 662 29 59.87 <0.0001
Asian 32 1 19 1 13 1 1.04 0.3068
Native Hawaiian or Pacific Islander 15 <1 10 <1 5 <1 2.16 0.1416
American Indian or Alaska Native 112 2 53 2 59 3 0.26 0.6132








Satisfaction with the Medicaid Program: HMO vs. MediPass (weighted)


Medicaid Overall HMO MediPass Tests of Significance

N % ors N % ors N % or s ort P
Received New Doctor or Nurse When Enrolled
Yes 1196 44 1089 48 908 40
No 2532 56 1184 52 1348 60

Problem Getting Satisfactory Doctor or Nurse
Big Problem 341 17 173 16 168 19
Small Problem 267 14 132 12 134 15 5.49 0.06556
No Problem 1350 69 754 71 596 66

Has a Personal Doctor or Nurse
Yes 3565 77 1712 74 1853 80 21.8
No 1056 23 592 26 464 20

Mean Rating of Doctor or Nurse 8.66 0.03 8.60 0.04 8.76 0.07 2.43 0.015

Needed a Specialist
Yes 1912 41 934 40 981 43
1.69 0.1932
No 2715 59 1375 60 1340 58

How Much of a Problem to Get Referral for Specialist
Big Problem 462 21 241 23 221 20
Small Problem 267 12 140 13 127 12 3.52 0.1724
Not a Problem 1434 66 689 64 745 68

Sawa Specialist
Yes 1912 41 931 40 981 42
1.69 0.1932
No 2715 59 1375 60 1340 58

Mean Rating of Specialist 8.59 0.05 8.52 0.06 8.62 0.12 0.9 0.3682

Specialist Same as Personal Doctor
Yes 502 26 245 27 258 26 0
No 1398 74 678 73 719 74

Called Doctor's Office for Self During Regular Hours
Yes 2277 49 1174 51 1104 48
No 92364 551 1146 49 1218 52 0.








Satisfaction with the Medicaid Program: HMO vs. MediPass (weighted)


Medicaid Overall HMO MediPass Tests of Significance

N % ors N % ors N % or s ort P
Received Needed Help or Advice as a Result of Call
Never 160 7 74 6 86 8
Sometimes 405 18 239 21 165 15
Usually 386 17 184 16 202 19
Always 1293 58 663 57 630 58

Made Appointment for Routine Health Care
Yes 2967 64 1528 65 1439 62
8.69 0.0032
No 1671 36 785 35 886 38


Got Appointment for Routine Health Care as Soon as Wanted
Never 122 4 65 4 57 4
Sometimes 468 16 257 17 211 15 4.
Usually 489 17 260 17 221 16
Always 1833 63 926 62 907 65


(Mean) Days Waited Between Making Appointment and Seeing Provider Not Asked Not Asked 3.96 0.10 N/A N/A
for Routine Care

Had Illness or Injury Needing Immediate Care
Yes 1960 43 960 41 1000 43
1.28 0.2575
No 2677 57 1356 59 1320 57


Got Immediate Care for Illness or Injury as Soon as Wanted
Never 121 6 71 7 50 5
Sometimes 322 17 158 17 163 17 77
Usually 263 14 129 14 133 13
Always 1231 64 589 62 642 65

(Mean) Days Waited Between Trying to Get Care and Seeing Provider for Not Asked Not Asked 2.57 0.11 N/A N/A
Not Asked Not Asked 2.57 + 0.11 N/A N/A
Illness or Injury

0.78 0.03 0.84 0.05 0.72 0.05 1.76 0.0787
(Mean) Number of Times Went to Emergency Room for Care for Self 0.78 0.03
I I I








Satisfaction with the Medicaid Program: HMO vs. MediPass (weighted)


Medicaid Overall HMO MediPass Tests of Significance

N % ors N % or s N % or s Xort P
(Mean) Number of Times Went to Doctor's Office or Clinic for Care for 3.66 0.03 3.59 0.03 3.73 0.07 2.21 0.027E
Self

How Much of a Problem to Get Necessary Care
Big Problem 440 13 239 14 201 12
Small Problem 505 15 293 17 212 13 13.01 0.0015
Not a Problem 2473 72 1230 70 1243 75

Delays While Waiting for Approval from Program
Big Problem 412 12 249 14 163 10
Small Problem 509 15 287 16 222 13 25.09 <0.0001
Not a Problem 2511 73 1228 70 1283 77


Waited More Than 15 Minutes Past Appointment Time to See Provider
Never 729 21 420 24 309 18
Sometimes 1365 40 706 40 659 39
Usually 436 13 208 12 227 14
Always 917 27 427 24 490 29


Office Staff at Doctor's Office Were Courteous and Respectful
Never 90 3 62 4 28 2
Sometimes 306 9 146 8 160 9 13.72 0.000
Usually 337 10 163 9 174 10
Always 2733 79 1403 79 1330 79

Office Staff at Doctor's Office Were Helpful
Never 110 3 72 4 38 2
Sometimes 557 16 302 17 255 15 .
Usually 527 15 275 16 252 15
Always 2250 65 1114 63 1136 68

Doctor or Other Provider Listened Carefully
Never 110 3 68 4 43 3
Sometimes 438 13 254 14 184 11 16
Usually 479 14 227 13 252 15
Always 2439 70 1226 69 1213 72








Satisfaction with the Medicaid Program: HMO vs. MediPass (weighted)


Medicaid Overall HMO MediPass Tests of Significance

N % ors N % ors N % ors 2ort P

Difficulty Communicating With Doctor Due to Language Barriers
Never 2618 76 1356 76 1261 74
Sometimes 563 15 255 14 308 18 12.14 0.0069
Usually 94 3 54 3 40 2
Always 198 6 114 6 86 5


Doctor Explained Things So That Patient Could Understand
Never 167 5 91 5 76 5
Sometimes 386 11 208 12 178 10
Usually 461 13 232 13 229 14
Always 2456 71 1244 70 1212 72

Doctor Showed Respect for What Patient Said
Never 120 4 82 5 38 2
Sometimes 434 12 247 14 187 11 23.22
Usually 452 13 225 13 227 13
Always 2467 71 1222 69 1245 73

Doctor Spent Enough Time With Patient
Never 169 5 101 6 68 4
Sometimes 553 16 307 17 246 15
Usually 556 16 276 16 280 17
Always 2177 63 1084 61 1093 65

8.37 + 0.04 8.24 + 0.04 8.51 0.08 3.67 0.0002
Mean Rating of All Health Care, from All Doctors and Health Providers 8.37 0.04 8.24 0.04 8.51 0.08 3.67 0.0002


Needed an Interpreter to Speak with Doctor or Other Health Provider
Yes 238 5 127 5 111 5 1.15 0.2832
No 4417 95 2201 95 2217 95

How Often Received a Needed Interpreter
Never 48 20 27 22 21 19
Sometimes 73 31 36 29 36 33 0.51 0.9166
Usually 9 4 4 4 5 4
Always 105 45 57 45 48 44








Satisfaction with the Medicaid Program: HMO vs. MediPass (weighted)


Medicaid Overall HMO MediPass Tests of Significance

N % ors N % ors N % ors 2ort P

Had a Choice of Health Plans
Yes 1831 85 N/A N/A
No 335 15


Use Current Medicaid Program for All or Most of Health Care
Yes 3954 95 1791 98 2163 94
No 188 5 37 2 151 6

3.76 0.01 3.76 0.02 3.76 0.02 -0.3 09763
Mean Number of Months in a Row Enrolled in This Program 3.76 0.01 3.76 0.02 3.76 0.02 -0.3 0.9763

Patient Choice of Program
Chose Myself 2270 57 1193 67 1077 50 121.58 <0.0001
Was Told 1683 43 588 33 1096 50

Received Information About Program When Enrolled
Yes 2758 70 1280 73 1478 68
No 1172 30 480 27 692 32

How Much of Given Information Was Correct
All of It 1644 63 742 60 902 66
Most of It 713 27 351 28 362 26
Some of It 225 9 133 11 92 7
None of It 31 1 14 1 16 1


Looked for Information in Written Materials from Program
Yes 1266 28 843 37 422 183
No 3334 72 1454 63 1879 82

How Much of a Problem to Find or Understand Information in Written
Materials
Big Problem 149 12 88 10 61 15
Small Problem 253 20 178 21 75 18 5.5 0.064
Not a Problem 848 68 573 68 275 67








Satisfaction with the Medicaid Program: HMO vs. MediPass (weighted)


Medicaid Overall HMO MediPass Tests of Significance

N % ors N % ors N % or s ort P

Called Program's Enrollee Service for Information or Help
Yes 1558 34 1064 46 495 22
306.61 <0.0001
No 3043 66 1247 54 1796 78

How Much of a Problem to Get Needed Help from Program's Enrollee
Service
Big Problem 374 24238 23 135 27
Small Problem 327 21 213 20 113 23 8.19 0.0167
Not a Problem 849 55 605 57 245 50

Called or Written to Program with Complaint or Problem
Yes 196 8
Yes Not Asked Not Asked 196 8 N/A N/A
No 2130 92

Length of Time to Resolve Complaint
Same Day 23 12
1Week 27 14
2 Weeks 12 6
2 Weeks Not Asked Not Asked 2 6 N/A N/A
3Weeks 6 3
4 or More Weeks 27 14
Still Waiting for Settlement 96 51

Complaint or Problem Settled to Your Satisfaction
Yes 89 45
No Not Asked Not Asked 42 21 N/A N/A
Still Waiting for Settlement 65 33

Experience with Paperwork for Program
Yes 723 16 396 17 327 14
No 3878 84 1899 83 1979 86

How Much of a Problem was the Paperwork for Program
Big Problem 105 15 69 17 37 11
Small Problem 156 22 96 24 61 19 11.2 0.0037
Not a Problem 459 64 230 58 229 70_

Mean Overall Rating of Health Plan 8.11 0.04 8.01 0.04 8.21 0.08 2.73 0.0064







Demographic Characteristics of Survey Respondents: MediPass Enrollees Residing in HMO Counties
vs. Non HMO Counties (weighted)

iPass Ov l Residents of HMO Residents of Non HMO T s o
MediPass Overall C CutTests of Significance
Counties Counties

N% ors N % ors N % ors 2 or t P
Self Assessed Overall Health
Excellent 100 11 86 12 14 9
Very Good 155 17 126 17 29 18
Good 210 24 172 23 38 25 2.62 0.6227
Fair 221 25 180 24 42 27
Poor 205 23 176 24 30 19

Mean Age 44.22 0.48 44.61 0.74 42.27 0.60 1.83 0.0681

Sex
Male 250 28 213 28 38 25
0.87 0.3505
Female 653 72 538 72 115 75

Highest School Grade Completed
8th Grade or Less 131 15 113 15 18 12
Some High School, but Didn't Graduate 203 23 165 22 39 26
High School Graduate, or GED 316 36 258 35 58 38
3.48 0.6262
Some College or 176 20 146 20 31 20
2-Year College Degree 37 4 33 4 5 3
4-Year College Degree or More 23 3 21 3 2 1

Hispanic or Latino Origin or Descent
Yes 188 21 178 24 10 7
22.52 <0.0001
No 702 79 563 76 139 93

Race
White 560 62 460 61 100 66 1.04 0.307
Black or African-American 255 28 211 28 44 29 0.07 0.7945
Asian 5 1 4 1 1 1 N/A N/A
Native Hawaiian or Pacific Islander 2 <1 2 <1 0 <1 N/A N/A
American Indian or Alaska Native 22 2 17 2 5 3 N/A N/A








Satisfaction with the Medicaid Program: MediPass Enrollees Residing in HMO Counties vs. Non HMO Counties (weighted)




Residents of Non HMO
MediPass Overall Residents of HMO Counties e s n Tests of Significance
Counties

N % or s N % or s N % or s 2 or t P
Received New Doctor or Nurse When Enrolled
Yes 350 40 291 40 59 40
0 0.9724
No 521 60 433 60 88 60

Problem Getting Satisfactory Doctor or Nurse
Big Problem 64 18 48 17 16 27
Small Problem 53 15 46 16 7 11 2.93 0.1403
No Problem 231 67 195 68 36 66

Has a Personal Doctor or Nurse
Yes 716 80 599 81 117 77
0.89 0.3463
No 178 20 144 19 34 23

Mean Rating of Doctor or Nurse 8.77 + 0.07 8.78 + 0.10 8.70 + 0.09 0.4 0.6889

Needed a Specialist 1.26 0.2614
Yes 414 46 190 49 224 44
1.26 0.2614
No 481 54 197 51 287 56


How Much of a Problem to Get Referral for Specialist
Big Problem 85 20 71 20 14 22
Small Problem 49 12 40 11 9 13 0.49 0.7824
Not a Problem 289 68 247 69 42 65

Saw a Specialist
Yes 380 42 322 43 59 39
No 516 58 423 57 93 61

Mean Rating of Specialist 8.62 : 0.12 8.63 0.17 8.56 : 0.16 0.23 0.8185

Specialist Same as Personal Doctor
Yes 99 26 82 26 17 29 059
No 2720.28 037744227
No 279 237 74 42 71








Satisfaction with the Medicaid Program: MediPass Enrollees Residing in HMO Counties vs. Non HMO Counties (weighted)




Residents of Non HMO
MediPass Overall Residents of HMO Counties e s n Tests of Significance
Counties

N % ors N % ors N % ors 2 or t P

Called Doctor's Office for Self During Regular Hours
Yes 425 47 347 47 78 52
1.29 0.2567
No 472 53 398 53 73 48


Received Needed Help or Advice as a Result of Call
Never 33 8 27 8 6 8
Sometimes 63 15 48 14 15 19 1.42
Usually 78 19 63 19 14 19
Always 243 58 201 59 42 54

Made Appointment for Routine Health Care
Yes 555 62 460 62 96 63 07 0
0.17 0.6818
No 343 38 287 38 56 37


Got Appointment for Routine Health Care as Soon as Wanted
Never 22 4 19 4 3 3
Sometimes 82 15 69 16 13 14 5 0.
5.67 0.1288
Usually 83 16 61 14 22 23
Always 351 65 295 66 56 60


(Mean) Days Waited Between Making Appointment and Seeing Provider for 3.97 +0.10 4.00 +0.16 3.80 +0.13 0.76 0.4466
Routine Care


Had Illness or Injury Needing Immediate Care
Yes 386 43 322 43 65 43 0
0.01 0.909O
No 510 57 423 57 87 57


Got Immediate Care for Illness or Injury as Soon as Wanted
Never 19 5 13 4 5 8
Sometimes 63 17 52 16 11 18 23
2.37 0.5
Usually 51 13 42 13 9 14
Always 249 65 211 66 38 60








Satisfaction with the Medicaid Program: MediPass Enrollees Residing in HMO Counties vs. Non HMO Counties (weighted)




Residents of Non HMO
MediPass Overall Residents of HMO Counties Tests of Significance
Counties

N % or s N % ors N % ors 2 or t P
(Mean) Days Waited Between Trying to Get Care and Seeing Provider for 2.57 0.11 2.57+0.17 2.57 0.14 0.01 0.990
Illness or Injury


0.72 0.07 0.71 0.07 0.78 0.07 -0.56 0.5765
Mean Number of Times Went to Emergency Room for Care for Self 0.72 +0.07 0.71 +0.07 0.78 +0.07 -0.56 0.576E


Mean Number of Times Went to Doctor's Office or Clinic for Care for Self 3.73 0.07 3.73 0.11 3.76 0.10 -0.17 0.867

How Much of a Problem to Get Necessary Care
Big Problem 77 12 63 12 14 12
Small Problem 80 13 59 11 21 18 4.44 0.1087
Not a Problem 481 75 402 77 79 69

Delays While Waiting for Approval from Program
Big Problem 63 10 52 10 11 10
Small Problem 85 13 71 13 15 13 0.01 0.9956
Not a Problem 494 77 408 77 87 77


Waited More Than 15 Minutes Past Appointment Time to See Provider
Never 119 18 100 19 20 18
Sometimes 252 39 199 37 53 47 3.73
Usually 88 14 75 14 13 12
Always 190 29 163 30 27 24


Office Staff at Doctor's Office Were Courteous and Respectful
Never 11 2 10 2 1 1
Sometimes 62 9 52 10 10 9 0.2 0.977
Usually 67 10 56 10 12 10
Always 512 79 421 78 91 80

Office Staff at Doctor's Office Were Helpful
Never 15 2 13 3 1 1
Sometimes 98 15 82 15 16 14
Usually 96 15 73 14 23 20
Always 439 68 366 68 73 64








Satisfaction with the Medicaid Program: MediPass Enrollees Residing in HMO Counties vs. Non HMO Counties (weighted)




Residents of Non HMO
MediPass Overall Residents of HMO Counties e s n Tests of Significance
Counties

N % or s N % or s N % or s 2 or t P
Doctor or Other Provider Listened Carefully
Never 16 3 13 2 3 3
Sometimes 71 11 57 11 13 12 0.0
Usually 97 15 80 15 17 15
Always 468 72 387 72 81 71


Difficulty Communicating with Doctor Due to Language Barriers
Never 485 74 394 73 90 80
Sometimes 120 18 105 20 15 133333
3.37 0.3523
Usually 15 2 11 2 4 3
Always 34 5 29 5 5 4


Doctor Explained Things so Patient Could Understand
Never 30 5 29 5 1 1
Sometimes 68 10 52 10 16 14
Usually 88 13 71 13 17 15
Always 468 72 389 72 79 70


Doctor Showed Respect for What Patient Said
Never 14 2 11 2 3 3
Sometimes 72 11 61 11 11 10 0. 00
Usually 87 13 69 13 18 16
Always 480 73 398 74 82 72

Doctor Spent Enough Time With Patient
Never 27 4 23 4 4 3
Sometimes 95 15 77 14 18 16 636
Usually 107 16 84 16 23 20
Always 422 65 352 66 70 61


Mean Rating of All Health Care, from All Doctors and Health Providers 8.52+0.08 8.54+0.13 8.40+0.10 0.72 0.4723
Mean Rating of All Health Care, from All Doctors and Health Providers 85 08 8. 14
I I I








Satisfaction with the Medicaid Program: MediPass Enrollees Residing in HMO Counties vs. Non HMO Counties (weighted)




Residents of Non HMO
MediPass Overall Residents of HMO Counties e s n Tests of Significance
Counties

N % ors N % ors N % ors 2 or t P

Needed an Interpreter to Speak with Doctor or Other Health Provider
Yes 43 5 33 5 5 3 0.88 0.3484
No 855 95 708 95 147 97

How Often Received a Needed Interpreter
Never 8 19 8 20 1 13
Sometimes 14 33 13 35 1 19 NA
N/A N/A
Usually 1 3 0 0 1 31
Always 19 44 17 45 2 38


Received Information About Program When Enrolled
Yes 567 68 458 66 110 76 7 0
5.57 0.0181
No 270 32 236 34 34 24

How Much of Given Information Was Correct
All of It 346 66 278 65 68 67
Most of It 139 26 113 27 26 26
Some of It 35 7 29 7 7
None of It 6 16 1 1 1

Looked for Information in Written Materials from Program
Yes 163 18 136 18 27 18 898
0.02 0.8948
No 725 82 601 82 124 82

How Much of a Problem to Find or Understand Information in Written
Materials
Big Problem 24 15 21 16 3 10
Small Problem 28 18 19 14 9 34 N/A N/A
Not a Problem 107 67 92 70 15 56


Called Program's Enrollee Service for Information or Help
Yes 192 22 163 22 29 19
No 692 78 569 78 123 81








Satisfaction with the Medicaid Program: MediPass Enrollees Residing in HMO Counties vs. Non HMO Counties (weighted)




Residents of Non HMO
MediPass Overall Residents of HMO Counties e s n Tests of Significance
Counties

N % ors N % ors N % ors 2 or t P
How Much of a Problem to Get Needed Help from Program's Enrollee
Service
Big Problem 52 27 44 27 8 29
Small Problem 43 23 34 21 9 31 1.85 0.3958
Not a Problem 96 50 84 52 11 40


Called or Written to Program with Complaint or Problem
Yes 76 8 65 9 11 7
No 822 92 679 91 142 93

Length of Time to Resolve Complaint
Same Day 9 12 8 12 1 11
1 Week 10 14 10 15 1 8
2 Weeks 5 6 4 6 1 8 N/A N/A
3 Weeks 2 3 3 2 0 2
4 or More Weeks 10 14 10 15 1 8
Still Waiting for Settlement 37 50 31 49 6 61


Complaint or Problem Settled to Your Satisfaction
Yes 35 46 31 47 4 38
No 17 22 15 24 1 11 N/A N/A
Still Waiting for Settlement 25 36 19 29 6 51

Experience with Paperwork for Program
es 126 14 101 14 24 16 054 04638
No 765 86 638 86 127 84


How Much of a Problem was the Paperwork for Program
Big Problem 14 11 11 11 3 11
Small Problem 23 19 19 19 4 18 N/A N/A
Not a Problem 88 70 71 70 17 71

Mean Overall Rating of Health Plan 8.21 + 0.08 8.23 + 0.12 8.12 + 0.10 0.51 0.6077











Appendix C:


MCO Enrollment Reports


Source: AHCA and DOI Websites








MEDIPASS/HMO/PSN RECIPIENT ENROLLMENT REPORT FOR
DECEMBER 2001


i m a m'' -Z m a U am ; m m O0 m a mO -u M a a r Oom O m Om m0

0 m 0 m3 mZ o V ma mz -q mS mm m -j M m 0mm v
-n D D Dm x D D 10 O 1 D O m z z
z -n m ; u I o
z r r, r, r. -0 > 0r- ) F m ; r, x r ; Fn
m mI M m ,u, z M -uz ; -az L
cl) 0 00 z n M 0 0 0 l 0-0 00 o oz c) 0 00 0 = 0 Boo = =


ESCAMBIA 27891 320 13063
OKALOOSA 8713 246 7043
SANTA ROSA 7367 139 4089
WALTON 3146 70 2636
AREA 01 TOTAL: 47117 775 26831

BAY 13695 334 11295
CALHOUN 1402 24 1164
FRANKLIN 839 17 704
GADSDEN 5861 34 2610
GULF 1189 17 1005
HOLMES 2383 57 1993
JACKSON 3831 48 3152
JEFFERSON 1318 9 561
LEON 14860 106 6975
LIBERTY 620 8 428
MADISON 1857 13 929
TAYLOR 2285 40 1911
WAKULLA 1583 23 824
WASHINGTON 2162 42 1781
AREA 02 TOTAL: 53885 772 35332

ALACHUA 17588 594 11403
BRADFORD 2669 73 2081
CITRUS 6816 118 4318
COLUMBIA 6545 188 5372
DIXIE 1717 48 1313
GILCHRIST 1779 74 1271
HAMILTON 1477 27 1264
HERNANDO 7856 109 2744
LAFAYETTE 646 17 567
LAKE 11162 115 4903
LEVY 2959 125 2066
MARION 19329 383 14055
PUTNAM 8548 154 5428
SUMTER 10319 210 7118
SUWANNEE 3072 74 2618
UNION 1016 49 726
AREA 03 TOTAL: 103498 2358 67247

BAKER 2072 49 1022
CLAY 4715 81 2591
DUVAL 55959 1055 22235
FLAGLER 1464 35 1143
NASSAU 2002 54 1104
ST JOHNS 4209 124 3339


STATE TOTAL: 1098838 14488


467494 491694


11228
0
2234
0
13462

0
0
0
2664
0
0
0
557
6015
82
700
0
626
0
10644

0
0
1522
0
0
0
0
4330
0
5927
0
2788
2001
0
0
0
16568

787
1717
25745
0
0
0
11897


5264 508886 3160 19181 5640 1853133 615658 585532 19137 50.45 47.98 1.57100.00


8233 245409

0 6173
0 1695
0 1193
0 586
0 9647

0 2457
0 287
0 200
0 1652
0 236
0 424
0 1114
0 414
0 2889
0 132
0 735
0 445
0 327
0 454
0 11766

0 3604
0 527
0 1190
0 1685
0 412
0 264
0 359
0 1604
0 88
0 2762
0 696
0 4478
0 1918
0 917
0 792
0 226
0 21522

0 361
0 966
0 13622
0 423
0 523
0 1217
0 6370


1898

62
31
19
6
118

25
1
1
8
2
8
7
0
12
1
5
1
4
6
81

64
6
8
20
10
6
0
20
0
17
20
36
15
9
9
5
245

4
11
123
6
8
16
43


145004

4152
1458
887
526
7023

2169
263
190
998
220
384
987
231
1728
112
514
417
226
406
8845

2747
469
938
1491
359
205
337
951
81
1670
578
3425
1493
833
695
194
16466

241
624
7967
372
349
1029
4039


74657

1500
0
204
0
1704

0
0
0
538
0
0
0
173
800
15
198
0
75
0
1799

0
0
148
0
0
0
0
448
0
832
0
604
310
0
0
0
2342

72
258
4493
0
0
0
1734


0 10520
0 4528
0 2848
0 1741
0 19637

0 6361
0 919
0 633
0 2579
0 698
0 1251
0 3072
0 823
0 5575
0 319
0 1154
0 969
0 682
0 1342
0 26377

0 6215
0 1189
0 4168
0 2781
0 789
0 705
0 709
0 3570
0 209
0 6100
0 1596
0 9468
0 3616
0 1951
0 1911
0 373
0 45350

0 731
0 1767
0 24485
0 812
0 1089
0 2841
0 13902


44
34
26
14
118

83
4
3
14
3
7
34
12
35
3
12
7
1
17
235

35
8
32
16
7
0
7
27
1
35
10
47
22
9
20
1
277

1
2
218
6
1
32
106


0 44584 17259 13008
0 14936 8535 0
0 11408 5002 2481
0 5473 3176 0
0 76401 33972 15489

0 22513 13547 0
0 2608 1431 0
0 1672 897 0
0 10092 3622 3386
0 2123 1228 0
0 4058 2384 0
0 8017 4173 0
0 2555 804 829
0 23324 8738 7059
0 1071 543 99
0 3746 1455 944
0 3699 2335 0
0 2592 1051 718
0 3958 2204 0
0 92028 44412 13035

0 27407 14185 0
0 4385 2558 0
0 12174 5288 1714
0 11011 6879 0
0 2918 1679 0
0 2748 1476 0
0 2545 1608 0
0 13030 3722 4871
0 943 649 0
0 20024 6608 6949
0 5251 2654 0
0 33275 17527 3488
0 14082 6943 2367
0 13187 7960 0
0 5775 3333 0
0 1615 921 0
0 170370 83990 19389

0 3164 1264 876
0 7448 3217 2044
0 94066 30420 31499
0 2699 1521 0
0 3614 1454 0
0 8267 4400 0
0 50230 18523 14059


0 57.02
0 100.00
0 66.84
0 100.00
0 68.68

0 100.00
0 100.00
0 100.00
0 51.68
0 100.00
0 100.00
0 100.00
0 49.23
0 55.31
0 84.58
0 60.65
0 100.00
0 59.41
0 100.00
0 77.31

0 100.00
0 100.00
0 75.52
0 100.00
0 100.00
0 100.00
0 100.00
0 43.31
0 100.00
0 48.74
0 100.00
0 83.40
0 74.58
0 100.00
0 100.00
0 100.00
0 81.24

0 59.07
0 61.15
0 49.13
0 100.00
0 100.00
0 100.00
0 56.85


42.98 0.00 100.00
0.00 0.00 100.00
33.16 0.00 100.00
0.00 0.00 100.00
31.32 0.00 100.00

0.00 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
48.32 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
50.77 0.00 100.00
44.69 0.00 100.00
15.42 0.00 100.00
39.35 0.00 100.00
0.00 0.00 100.00
40.59 0.00 100.00
0.00 0.00 100.00
22.69 0.00 100.00

0.00 0.00 100.00
0.00 0.00 100.00
24.48 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
56.69 0.00 100.00
0.00 0.00 100.00
51.26 0.00 100.00
0.00 0.00 100.00
16.60 0.00 100.00
25.42 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
18.76 0.00 100.00

40.93 0.00 100.00
38.85 0.00 100.00
50.87 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
0.00 0.00 100.00
43.15 0.00 100.00


29958 312


IVOLUSIA




ENR1201


14378








MEDIPASS/HMO/PSN RECIPIENT ENROLLMENT REPORT FOR
DECEMBER 2001


Sm m m m m m mZ m Z m mO mO m mM mM Hm Hm m m
S0 > >2 13 9 | 0 367o 31 13 o 1o" 0 44q 00 100
m- o 4n m LA L P A P P 3 q m m mP a a Pm zz Pz
I aA Z 8 nZ a. 0 7-3 7 a 40 a> 9 2r" o ". 0 ao .0
zq m < m m m z mm m m o m m m H mm- m m_
M E 3 6 38 D1 0 24 0 z 2 523 10631 0 3 D Z = 0 00
AREA 04 TOTAL: 100379 1710 45812 40146 0 23482 211 14621 6557 0 45627 366 1775 0 169488 60799 48478 0 55.64 44.36 0.00 100.00

PASCO 19933 226 7585 10972 0 5168 47 3086 1486 0 10722 105 393 0 35823 10776 12851 0 45.61 54.39 0.00 100.00
PINELLAS 49410 502 17080 24440 0 11384 86 6278 4012 0 25751 214 1041 0 86545 23572 29493 0 44.42 55.58 0.00 100.00
AREA 05 TOTAL: 69343 728 24665 35412 0 16552 133 9364 5498 0 36473 319 1434 0 122368 34348 42344 0 44.79 55.21 0.00 100.00

HARDEE 3776 83 3181 0 0 520 2 460 0 0 1385 9 0 0 5681 3650 0 0 100.00 0.00 0.00 100.00
HIGHLANDS 6575 83 3568 2332 0 1431 7 906 400 0 3192 19 107 0 11198 4493 2839 0 61.28 38.72 0.00 100.00
HILLSBOROUGH 77322 659 22565 49109 0 19388 125 9058 9104 0 31176 150 2014 0 127886 31773 60227 0 34.54 65.46 0.00 100.00
MANATEE 14386 60 3887 9215 0 2643 13 1313 1074 0 6265 34 342 0 23294 5234 10631 0 32.99 67.01 0.00 100.00
POLK 43244 211 9036 29896 0 9584 36 3440 5461 0 16923 48 1569 0 69751 12524 36926 0 25.33 74.67 0.00 100.00
AREA 06 TOTAL: 145303 1096 42237 90552 0 33566 183 15177 16039 0 58941 260 4032 0 237810 57674 110623 0 34.27 65.73 0.00 100.00
BREVARD 21819 170 8591 12348 0 5970 41 3532 1951 0 11605 96 367 0 39394 12219 14666 0 45.45 54.55 0.00 100.00
ORANGE 77090 808 24815 38360 0 15976 100 8337 6422 0 28076 174 1378 0 121142 33326 46160 0 41.93 58.07 0.00 100.00
OSCEOLA 13056 144 3616 9341 0 2349 18 1192 1136 0 5578 21 286 0 20983 4829 10763 0 30.97 69.03 0.00 100.00
SEMINOLE 7962 69 2308 8430 0 3438 14 1896 1237 0 5128 39 318 0 16528 4243 9985 0 29.82 70.18 0.00 100.00
AREA 07 TOTAL: 119927 1191 39330 68479 0 27733 173 14957 10746 0 50387 330 2349 0 198047 54617 81574 0 40.10 59.90 0.00 100.00
CHARLOTTE 4768 136 3761 0 0 1128 20 955 0 0 3593 20 0 0 9489 4736 0 0 100.00 0.00 0.00 100.00
COLLIER 12199 285 9498 0 0 1434 35 1230 0 0 5125 42 0 0 18758 10770 0 0 100.00 0.00 0.00 100.00
DESOTO 2856 56 2375 0 0 578 8 504 0 0 1164 6 0 0 4598 2885 0 0 100.00 0.00 0.00 100.00
GLADES 0 0 0 0 0 63 0 50 0 0 52 0 0 0 115 50 0 0100.00 0.00 0.00 100.00
HENDRY 4623 107 3050 827 0 558 8 421 47 0 1550 10 1 0 6731 3481 875 0 79.91 20.09 0.00 100.00
LEE 23943 237 7888 13811 0 4523 39 2242 1936 0 10660 75 544 0 39126 10205 16291 0 38.52 61.48 0.00 100.00
SARASOTA 9563 78 3410 5902 0 2263 16 1235 797 0 7028 54 261 0 18854 4699 6960 0 40.30 59.70 0.00 100.00
AREA 08 TOTAL: 57952 899 29982 20540 0 10547 126 6637 2780 0 29172 207 806 0 97671 36826 24126 0 60.42 39.58 0.00 100.00
INDIAN RIVER 5325 175 4150 0 0 1002 16 873 0 0 3023 51 0 0 9350 5074 0 0 100.00 0.00 0.00 100.00
MARTIN 5261 82 2877 1799 0 1004 8 706 242 0 2434 32 43 0 8699 3615 2084 0 63.43 36.57 0.00 100.00
OKEECHOBEE 3293 86 2655 0 0 616 6 565 0 0 1492 16 0 0 5401 3236 0 0 100.00 0.00 0.00 100.00
PALM BEACH 55946 590 21951 30033 0 10114 55 6002 3158 0 23324 155 486 0 89384 28108 33677 0 45.49 54.51 0.00 100.00
ST LUCIE 15783 282 10278 3325 0 3624 34 2800 538 0 6366 101 98 0 25773 13179 3961 0 76.89 23.11 0.00 100.00
AREA 09 TOTAL: 85608 1215 41911 35157 0 16360 119 10946 3938 0 36639 355 627 0 138607 53212 39722 0 57.26 42.74 0.00 100.00
BROWARD 85860 746 23099 52132 1865 18933 124 9086 7054 1333 35632 185 1252 1958 140425 32370 60438 5156 33.04 61.69 5.26 100.00
AREA 10 TOTAL: 85860 746 23099 52132 1865 18933 124 9086 7054 1333 35632 185 1252 1958 140425 32370 60438 5156 33.04 61.69 5.26 100.00

DADE 226839 2919 88540 108602 6368 54510 372 31201 16200 3931 122528 423 5512 3682 403877 120164 130314 13981 45.44 49.28 5.29 100.00
MONROE 3127 79 2508 0 0 791 13 681 0 0 2123 85 0 0 6041 3274 0 0 100.00 0.00 0.00 100.00
AREA 11 TOTAL: 229966 2998 91048 108602 6368 55301 385 31882 16200 3931 124651 508 5512 3682 409918 123438 130314 13981 46.10 48.67 5.22 100.00
STATE TOTAL: 1098838 14488 467494 491694 8233 245409 1898 145004 74657 5264 508886 3160 19181 5640 1853133 615658 585532 19137 50.45 47.98 1.57 100.00


ENR1201















Florida HMO Enrollment

Medicaid

As of December 31, 2001

Health Maintenance Oraanization


Alachua Baker Bav Bradford Brevard Broward Calhoun Charlotte Citrus Clav


Aetna U.S. Healthcare 0 0 0 0 0 0 0 0 0 0
American Medical Healthcare 0 0 0 0 0 0 0 0 0 0
America's Health Choice Medical Plan, Inc. (M+C Only) 0 0 0 0 0 0 0 0 0 0
AmeriHealth of Florida, Inc. 0 0 0 0 0 0 0 0 0 0
AvMed, Inc. 0 0 0 0 0 15 0 0 0 0
Beacon Health Plans, Inc. 0 0 0 0 0 7,951 0 0 0 0
Capital Group Health Services of Florida 0 0 0 0 0 0 0 0 0 0
CIGNA Healthcare of Florida, Inc. 0 0 0 0 0 0 0 0 0 0
Florida 1st Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Florida Health Care Plans 0 0 0 0 0 0 0 0 0 0
Foundation Health, A Florida Health Plan, Inc. 0 0 0 0 0 6,167 0 0 0 0
HealthCare USA, Inc. 0 0 0 0 0 0 0 0 0 0
HealthEase of Florida 0 876 0 0 6,482 2,875 0 0 1,713 2,041
Health First Health Plans, Inc. 0 0 0 0 0 0 0 0 0 0
Health Options, Inc. 0 0 0 0 0 0 0 0 0 0
Health Options Connect, Inc. (aka Principal Health Care of o0 0 0 0 0 0 0 0 0 0
Healthplan Southeast 0 0 0 0 0 1,169 0 0 0 0
Healthy Palm Beaches, Inc. 0 0 0 0 0 0 0 0 0 0
Humana Medical Plan, Inc. 1,232 165 0 226 1,044 4,370 0 115 223 311
Mayo Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Neighborhood Health Partnership 0 0 0 0 0 3 0 0 0 0
One Health Plan of Florida, Inc. 0 0 0 0 0 0 0 0 0 0
Physicians Healthcare Plan, Inc. 0 0 0 0 0 7,306 0 0 0 0
Preferred Care Partners, Inc. 0 0 0 0 0 0 0 0 0 0
Preferred Choice, the HMO of Florida Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
Preferred Medical Plan, Inc. 0 0 0 0 0 2,038 0 0 0 0
Prudential Health Care Plan, Inc. (Florida Division) 0 0 0 0 0 0 0 0 0 0
Public Health Trust of Dade County, The 0 0 0 0 0 0 0 0 0 0
Total Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
United HealthCare of Florida, Inc. 0 0 0 0 0 7,000 0 0 0 0
Vista Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Well Care HMO, Inc 0 0 0 0 8,180 13,121 0 0 0 0
TOTAL 1,232 1,041 0 226 15,706 52,015 0 115 1,936 2,352















Florida HMO Enrollment

Medicaid

As of December 31, 2001

Health Maintenance Oraanization


Collier Columbia Dade De Soto Dixie Duval Escambia


Flaaler Franklin Gadsden


Aetna U.S. Healthcare o 0 0 0 0 0 0 0 0 0
American Medical Healthcare 0 0 0 0 0 0 0 0 0 0
America's Health Choice Medical Plan, Inc. (M+C Only) 0 0 0 0 0 0 0 0 0 0
AmeriHealth of Florida, Inc. o 0 0 0 0 0 0 0 0 0
AvMed, Inc. 0 0 1,534 0 0 0 0 0 0 0
Beacon Health Plans, Inc. 0 0 6,327 0 0 0 0 0 0 0
Capital Group Health Services of Florida 0 0 0 0 0 0 0 0 0 0
CIGNA Healthcare of Florida, Inc. 0 0 0 0 0 0 0 0 0 0
Florida 1st Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Florida Health Care Plans 0 0 0 0 0 0 0 0 0 0
Foundation Health, A Florida Health Plan, Inc. 0 0 9,151 0 0 0 0 0 0 0
HealthCare USA, Inc. 0 0 0 0 0 0 0 0 0 0
HealthEase of Florida 0 0 5,058 0 2 31,493 13,002 0 0 1,814
Health First Health Plans, Inc. 0 0 0 0 0 0 0 0 0 0
Health Options, Inc. 0 0 0 0 0 0 0 0 0 0
Health Options Connect, Inc. (aka Principal Health Care of 1 o 0 0 0 0 0 0 0 0 0
Healthplan Southeast 0 0 1,642 0 0 0 0 0 1 1,545
Healthy Palm Beaches, Inc. 0 0 0 0 0 0 0 0 0 0
Humana Medical Plan, Inc. 0 235 10,093 0 62 5,055 3,225 0 0 531
Mayo Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Neighborhood Health Partnership 0 0 13,755 0 0 0 0 0 0 0
One Health Plan of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Physicians Healthcare Plan, Inc. 0 0 13,440 0 0 0 0 0 0 0
Preferred Care Partners, Inc. o 0 0 0 0 0 0 0 0 0
Preferred Choice, the HMO of Florida Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
Preferred Medical Plan, Inc. 0 0 9,215 0 0 0 0 0 0 0
Prudential Health Care Plan, Inc. (Florida Division) 0 0 0 0 0 0 0 0 0 0
Public Health Trust of Dade County, The 0 0 8,674 0 0 0 0 0 0 0
Total Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
United HealthCare of Florida, Inc. 0 0 20,398 0 0 0 0 0 0 0
Vista Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Well Care HMO, Inc 0 0 17,289 0 0 0 0 0 0 0
TOTAL 0 235 116,576 0 64 36,548 16,227 0 1 3,890















Florida HMO Enrollment

Medicaid

As of December 31, 2001

Health Maintenance Oraanization


Gilchrist Glades Gulf Hamilton Hardee Hendrv Hernando Hiahlands Hillsborouqh


Holmes


Aetna U.S. Healthcare 0 0 0 0 0 0 0 0 0 0
American Medical Healthcare 0 0 0 0 0 0 0 0 0 0
America's Health Choice Medical Plan, Inc. (M+C Only)0 0 0 0 0 0 0 0 0 0
AmeriHealth of Florida, Inc. o 0 0 0 0 0 0 0 0 0
AvMed, Inc. 0 0 0 0 0 0 0 0 5,841 0
Beacon Health Plans, Inc. 0 0 0 0 0 879 0 0 0 0
Capital Group Health Services of Florida 0 0 0 0 0 0 0 0 0 0
CIGNA Healthcare of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Florida 1st Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Florida Health Care Plans o 0 0 0 0 0 0 0 0 0
Foundation Health, A Florida Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
HealthCare USA, Inc. o 0 0 0 0 0 0 0 0 0
HealthEase of Florida 0 0 0 0 0 0 0 1,462 10,205 0
Health First Health Plans, Inc. o 0 0 0 0 0 0 0 0 0
Health Options, Inc. 0 0 0 0 0 0 0 0 0 0
Health Options Connect, Inc. (aka Principal Health Care of 1 o 0 0 0 0 0 0 0 0 0
Healthplan Southeast 0 0 0 0 0 0 0 0 0 0
Healthy Palm Beaches, Inc. o 0 0 0 0 0 0 0 0 0
Humana Medical Plan, Inc. 52 0 0 0 0 0 0 269 1,907 0
Mayo Health Plan, Inc. o 0 0 0 0 0 0 0 0 0
Neighborhood Health Partnership 0 0 0 0 0 0 0 0 0 0
One Health Plan of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Physicians Healthcare Plan, Inc. 0 0 0 0 0 0 0 0 24,726 0
Preferred Care Partners, Inc. o 0 0 0 0 0 0 0 0 0
Preferred Choice, the HMO of Florida Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
Preferred Medical Plan, Inc. o 0 0 0 0 0 0 0 0 0
Prudential Health Care Plan, Inc. (Florida Division) 0 0 0 0 0 0 0 0 0 0
Public Health Trust of Dade County, The o 0 0 0 0 0 0 0 0 0
Total Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
United HealthCare of Florida, Inc. 0 0 0 0 0 0 0 1,489 0 0
Vista Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Well Care HMO, Inc 0 0 0 0 0 0 4,870 0 19,422 0
TOTAL 52 0 0 0 0 879 4,870 3,220 62,101 0















Florida HMO Enrollment

Medicaid

As of December 31, 2001

Health Maintenance Oraanization


Indian River Jackson


Jefferson Lafavette


Lake


Lee Leon Levy Liberty Madison


Aetna U.S. Healthcare 0 0 0 0 0 0 0 0 0 0
American Medical Healthcare 0 0 0 0 0 0 0 0 0 0
America's Health Choice Medical Plan, Inc. (M+C Only) 0 0 0 0 0 0 0 0 0 0
AmeriHealth of Florida, Inc. o 0 0 0 0 0 0 0 0 0
AvMed, Inc. 0 0 0 0 0 2,313 0 0 0 0
Beacon Health Plans, Inc. o 0 0 0 0 0 0 0 0 0
Capital Group Health Services of Florida 0 0 0 0 0 0 0 0 0 0
CIGNA Healthcare of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Florida 1st Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Florida Health Care Plans o 0 0 0 0 0 0 0 0 0
Foundation Health, A Florida Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
HealthCare USA, Inc. o 0 0 0 0 0 0 0 0 0
HealthEase of Florida 0 0 553 0 2,892 0 3,369 0 0 457
Health First Health Plans, Inc. o 0 0 0 0 0 0 0 0 0
Health Options, Inc. 0 0 0 0 0 0 0 0 0 0
Health Options Connect, Inc. (aka Principal Health Care of 1 o 0 0 0 0 0 0 0 0 0
Healthplan Southeast 0 0 280 0 0 0 3,644 0 101 511
Healthy Palm Beaches, Inc. o 0 0 0 0 0 0 0 0 0
Humana Medical Plan, Inc. 0 0 200 0 591 338 955 307 0 107
Mayo Health Plan, Inc. o 0 0 0 0 0 0 0 0 0
Neighborhood Health Partnership 0 0 0 0 0 0 0 0 0 0
One Health Plan of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Physicians Healthcare Plan, Inc. 0 0 0 0 0 9,324 0 0 0 0
Preferred Care Partners, Inc. o 0 0 0 0 0 0 0 0 0
Preferred Choice, the HMO of Florida Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
Preferred Medical Plan, Inc. o 0 0 0 0 0 0 0 0 0
Prudential Health Care Plan, Inc. (Florida Division) 0 0 0 0 0 0 0 0 0 0
Public Health Trust of Dade County, The o 0 0 0 0 0 0 0 0 0
Total Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
United HealthCare of Florida, Inc. o 0 0 0 3,959 0 0 0 0 0
Vista Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Well Care HMO, Inc 0 0 0 0 0 4,635 0 0 0 0
TOTAL 0 0 1,033 0 7,442 16,610 7,968 307 101 1,075















Florida HMO Enrollment

Medicaid

As of December 31, 2001

Health Maintenance Oraanization


Manatee Marion Martin Monroe Nassau Okaloosa Okeechobee


Orange Osceola Palm Beach


Aetna U.S. Healthcare 0 0 0 0 0 0 0 0 0 0
American Medical Healthcare 0 0 0 0 0 0 0 0 0 0
America's Health Choice Medical Plan, Inc. (M+C Only 0 0 0 0 0 0 0 0 0 0o
AmeriHealth of Florida, Inc. o 0 0 0 0 0 0 0 0 0
AvMed, Inc. 930 0 0 0 0 0 0 1,963 0 0
Beacon Health Plans, Inc. 0 0 0 0 0 0 0 0 0 4,773
Capital Group Health Services of Florida 0 0 0 0 0 0 0 0 0 0
CIGNA Healthcare of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Florida 1st Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Florida Health Care Plans o 0 0 0 0 0 0 0 0 0
Foundation Health, A Florida Health Plan, Inc. 0 0 0 0 0 0 0 0 0 9,097
HealthCare USA, Inc. o 0 0 0 0 0 0 0 0 0
HealthEase of Florida 2,247 3,487 735 0 0 0 0 5,835 3,134 1,761
Health First Health Plans, Inc. o 0 0 0 0 0 0 0 0 0
Health Options, Inc. 0 0 0 0 0 0 0 0 0 0
Health Options Connect, Inc. (aka Principal Health Care of 1 o 0 0 0 0 0 0 0 0 0
Healthplan Southeast 0 0 0 0 0 0 0 0 0 1,047
Healthy Palm Beaches, Inc. 0 0 0 0 0 0 0 0 0 4,138
Humana Medical Plan, Inc. 1,325 867 253 0 183 0 86 2,464 542 1,641
Mayo Health Plan, Inc. o 0 0 0 0 0 0 0 0 0
Neighborhood Health Partnership 0 0 0 0 0 0 0 0 0 0
One Health Plan of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Physicians Healthcare Plan, Inc. 0 0 0 0 0 0 0 11,556 2,475 4,407
Preferred Care Partners, Inc. o 0 0 0 0 0 0 0 0 0
Preferred Choice, the HMO of Florida Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
Preferred Medical Plan, Inc. o 0 0 0 0 0 0 0 0 0
Prudential Health Care Plan, Inc. (Florida Division) 0 0 0 0 0 0 0 0 0 0
Public Health Trust of Dade County, The o 0 0 0 0 0 0 0 0 0
Total Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
United HealthCare of Florida, Inc. 0 0 0 0 0 0 3 9,944 2,039 0
Vista Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Well Care HMO, Inc 7,457 0 0 0 0 0 0 17,022 3,188 8,216
TOTAL 11,959 4,354 988 0 183 0 89 48,784 11,378 35,080















Florida HMO Enrollment

Medicaid

As of December 31, 2001

Health Maintenance Oraanization


Pasco Pinellas Polk Putnam Santa Rosa


Sarasota Seminole St. Johns St. Lucie


Sumter


Aetna U.S. Healthcare 0 0 0 0 0 0 0 0 0 0
American Medical Healthcare 0 0 0 0 0 0 0 0 0 0
America's Health Choice Medical Plan, Inc. (M+C Only] 0 0 0 0 0 0 0 0 0 0
AmeriHealth of Florida, Inc. o 0 0 0 0 0 0 0 0 0
AvMed, Inc. 1,446 3,603 1,452 0 0 0 0 0 0 0
Beacon Health Plans, Inc. o 0 0 0 0 0 0 0 0 0
Capital Group Health Services of Florida 0 0 0 0 0 0 0 0 0 0
CIGNA Healthcare of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Florida 1st Health Plan, Inc. 0 0 3,132 0 0 0 0 0 0 0
Florida Health Care Plans o 0 0 0 0 0 0 0 0 0
Foundation Health, A Florida Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
HealthCare USA, Inc. o 0 0 0 0 0 0 0 0 0
HealthEase of Florida 2,550 4,894 5,719 2,366 2,477 1,287 1,452 0 0 0
Health First Health Plans, Inc. o 0 0 0 0 0 0 0 0 0
Health Options, Inc. 0 0 0 0 0 0 0 0 0 0
Health Options Connect, Inc. (aka Principal Health Care of 1 o 0 0 0 0 0 0 0 0 0
Healthplan Southeast 0 0 0 0 0 0 0 0 0 0
Healthy Palm Beaches, Inc. o 0 0 0 0 0 0 0 0 0
Humana Medical Plan, Inc. 539 1,490 943 627 557 353 709 467 0 0
Mayo Health Plan, Inc. o 0 0 0 0 0 0 0 0 0
Neighborhood Health Partnership 0 0 0 0 0 0 0 0 0 0
One Health Plan of Florida, Inc. o 0 0 0 0 0 0 0 0 0
Physicians Healthcare Plan, Inc. 5,128 10,734 8,629 0 0 3,695 3,101 0 0 0
Preferred Care Partners, Inc. 0 0 0 0 0 0 0 0 0 0
Preferred Choice, the HMO of Florida Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
Preferred Medical Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Prudential Health Care Plan, Inc. (Florida Division) 0 0 0 0 0 0 0 0 0 0
Public Health Trust of Dade County, The 0 0 0 0 0 0 0 0 0 0
Total Health Choice, Inc. 0 0 0 0 0 0 0 0 0 0
United HealthCare of Florida, Inc. 0 0 0 0 0 0 3,086 0 0 0
Vista Health Plan, Inc. 0 0 0 0 0 0 0 0 0 0
Well Care HMO, Inc 3,718 10,257 18,005 0 0 1,963 2,404 0 0 0
TOTAL 13,381 30,978 37,880 2,993 3,034 7,298 10,752 467 0 0















Florida HMO Enrollment

Medicaid

As of December 31, 2001

Health Maintenance Oraanization


Suwannee Taylor Union Volusia Wakulla Walton Washinaton


Other TOTALS


Aetna U.S. Healthcare 0 0 0 0 0 0 0 0 0
American Medical Healthcare 0 0 0 0 0 0 0 0 0
America's Health Choice Medical Plan, Inc. (M+C Only)0 0 0 0 0 0 0 0 0o
AmeriHealth of Florida, Inc. o 0 0 0 0 0 0 0 0
AvMed, Inc. 0 0 0 0 0 0 0 0 19,097
Beacon Health Plans, Inc. 0 0 0 0 0 0 0 0 19,930
Capital Group Health Services of Florida 0 0 0 0 0 0 0 0 0
CIGNA Healthcare of Florida, Inc. o 0 0 0 0 0 0 0 0
Florida 1st Health Plan, Inc. 0 0 0 0 0 0 0 0 3,132
Florida Health Care Plans 0 0 0 0 0 0 0 0 0
Foundation Health, A Florida Health Plan, Inc. 0 0 0 0 0 0 0 0 24,415
HealthCare USA, Inc. 0 0 0 0 0 0 0 0 0
HealthEase of Florida 0 0 0 5,883 253 0 0 0 128,374
Health First Health Plans, Inc. o 0 0 0 0 0 0 0 0
Health Options, Inc. 0 0 0 0 0 0 0 0 0
Health Options Connect, Inc. (aka Principal Health Care of 1 o 0 0 0 0 0 0 0 0
Healthplan Southeast 0 0 0 0 503 0 0 0 10,443
Healthy Palm Beaches, Inc. 0 0 0 0 0 0 0 0 4,138
Humana Medical Plan, Inc. 0 0 81 1,400 37 0 0 0 46,177
Mayo Health Plan, Inc. o 0 0 0 0 0 0 0 0
Neighborhood Health Partnership 0 0 0 0 0 0 0 0 13,758
One Health Plan of Florida, Inc. o 0 0 0 0 0 0 0 0
Physicians Healthcare Plan, Inc. 0 0 0 0 0 0 0 0 104,521
Preferred Care Partners, Inc. o 0 0 0 0 0 0 0 0
Preferred Choice, the HMO of Florida Health Choice, Inc. 0 0 0 0 0 0 0 0 0
Preferred Medical Plan, Inc. 0 0 0 0 0 0 0 0 11,253
Prudential Health Care Plan, Inc. (Florida Division) 0 0 0 0 0 0 0 0 0
Public Health Trust of Dade County, The 0 0 0 0 0 0 0 0 8,674
Total Health Choice, Inc. 0 0 0 0 0 0 0 0 0
United HealthCare of Florida, Inc. 0 0 0 8,484 0 0 0 0 56,402
Vista Health Plan, Inc. 0 0 0 0 0 0 0 0 0
Well Care HMO, Inc 0 0 0 0 0 0 0 0 139,747
TOTAL 0 0 81 15,767 793 0 0 0 590,061












Appendix D: Hispanic Enrollment by County


Source: Data run by AHCA







Hispanic Enrollment in Counties with HMOs and Without HMOs


HMO Counties


Number of Number of
Number of
County HMOs Medicaid Hispanic
S HMOs __
Enrollees Enrollees
Bay 0 23612 299
Calhoun 0 2688 5C
Collier 0 19935 8119
DeSoto 0 5170 1153
Flagler 0 3611 154
Franklin 0 1605 5
Glades 0 130 1
Gulf 0 2157 1C
Hamilton 0 2649 20C
Hardee 0 6000 2832
Holmes 0 4238 63
Indian River 0 10543 1035
Jackson 0 8233 92
Lafayette 0 1009 79
Monroe 0 6726 1592
Okaloosa 0 16366 36C
St. Lucie 0 28563 2798
Sumter 0 15516 1129
Suwannee 0 6193 288
Taylor 0 3801 26
Walton 0 6249 86
Washington 0 4165 24


1879400 369745


Non-HMO Counties


Number of Number of
Number of
County HMOs Medicaid Hispanic
HMOs
Enrollees Enrollees
,lachua 1 29100 852
Bradford 1 4498 48
Charlotte 1 10825 597
Columbia 1 11628 218
3ilchrist 1 3104 95
-endry 1 7233 2562
-lernando 1 13939 808
_evy 1 5567 133
iberty 1 1048 43
\assau 1 3958 28
Dkeechobee 1 6450 1452
St. Johns 1 8921 121
Jnion 1 1768 40
3aker 2 3502 22
Citrus 2 13217 303
Clay 2 8381 306
Dixie 2 2982 23
Duval 2 103650 3026
Escambia 2 46533 434
Vlarion 2 34957 2832
Vlartin 2 9295 1897
Dutnam 2 14702 1305
Santa Rosa 2 12614 145
3revard 3 41366 1978
3adsden 3 10267 579
-lighlands 3 12163 2302
Jefferson 3 2638 26
_ake 3 22187 2232
_eon 3 26615 558
Vladison 3 3768 47
\olusia 3 55725 5611
/Vakulla 3 2843 23
_ee 4 48758 9721
Vlanatee 4 24525 4736
Sarasota 4 19324 1278
-lillsborough 5 132766 29238
Dsceloa 5 26258 12083
"asco 5 40005 2887
"inellas 5 107937 8906
Seminole 5 19654 2341
Range 6 140868 34455
Dolk 6 76058 10106
Dalm Beach 8 104793 20595
3roward 10 168593 26580
Vliami-Dade 12 434417 176173


Total


179159


20395


Total




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