January 28, 2004
Source: The Executive Office of The Governor

Sound principles of quality, competition and technology to increase patient access and modernize Florida’s health care market

TAMPA--Governor Jeb Bush today discussed his health care insurance reform proposals while at Tampa General Hospital. The Governor’s visit was part of a statewide tour with Lt. Governor Toni Jennings, members of the Legislature and the Governor’s agencies.

The Bush/Jennings proposals will increase patient access to care and modernize Florida’s health care marketplace by using new information technologies and expanding choices for individuals and small businesses. The goal is to improve the overall quality of care for all Floridians and will empower patients to make more informed decisions, ensuring access to affordable health insurance while preserving a sound economic environment for small businesses.

“Our health care system is second to none, but rising insurance costs are pushing it beyond the reach of far too many Floridians,” said Governor Jeb Bush. “The reforms we propose today focus on harnessing the same power of technology that drives medical advances and using it to transform the way health care services are delivered to patients in our state. If we can enhance quality of care and help patients make informed health care decisions, we will increase access to insurance in this state, and ultimately access to care.”

Governor Bush and Lt. Governor Jennings recognize that any reform proposal must also take into account that some of those currently uninsured choose not to spend money on insurance. Thirty-nine percent of uninsured individuals are between the ages of 18 and 29. At the same time, many Floridians desperately seek options to insure themselves and their families. Governor Bush and Lt. Governor Jennings remain concerned that all Floridians gain access to quality care and propose a number of specific reforms, consistent with the working recommendations of the Governor’s Task Force on access to Affordable Health Insurance. The reforms focus on creating a quality health care system that emphasizes patient safety, empowering patients and increasing access to quality health plans.

Governor Bush was joined by Department of Elderly Affairs Secretary Terry White, Agency for Health Care Administration Secretary Dr. Rhonda Medows, Representative Frank Farkas, Senator Durell Peaden, Representative Sandra Murman, Representative Kevin Ambler and Representative Heather Fiorentino.

The Lt. Governor also discussed the healthcare insurance reform plan at Jackson Memorial Hospital in Miami and Memorial Regional Hospital in Hollywood.

A Quality Health Care System that Emphasizes Patient Safety

• Improving Health Care through Technology: Governor Bush and Lt. Governor Jennings propose using technology to promote the flow of information between doctors, hospitals and all other health care providers while protecting patients’ confidentiality and privacy. As part of this proposal, the Governor calls for the implementation of an electronic medical records system. He will appoint an advisory group that will make recommendations to establish this system, protect patient privacy, anticipate costs, develop timelines for implementation, and work with the federal government to ensure compatibility with national efforts. The Governor and Lieutenant Governor will ask the Legislature to create incentives for those who participate in this program. These may include initiatives such as a pay-for-performance model that will reward participating providers by granting them higher reimbursements through Medicaid. The goal is for this infrastructure to be in place by December 2006. The Bush/Jennings recommended budget for Fiscal Year 2004-05 includes $2 million toward development of this system.
• New Licensure Standards that Focus on Patient Safety: The Bush/Jennings proposal also calls for a modern approach to licensure standards for hospitals. The new system will tie regulatory approval to quality standards. Furthermore, the Bush/Jennings proposal would revise the certificate of need process for health care facilities. Quality, instead of market share, will become the standard a hospital must meet to maintain a license to perform open-heart surgeries. This change will ensure that patient safety is the top goal of regulatory decision-making.

Empowering Patients

• Promote Health Savings Accounts (HSAs): Governor Bush and Lt. Governor Jennings recommend taking full advantage of Health Savings Accounts, which give patients greater control over their health care dollars. HSAs provide several benefits to Floridians and their employers and are an innovative way to create a competitive, consumer-driven health care market. HSAs allow individuals or their employers to contribute money on a tax-free basis into a savings account as long as the participant is also enrolled in a high-deductible insurance plan. Once enrolled, participants control the way they spend the money in their account. These pre-tax contributions can be invested, allowed to grow tax free, and can be taken with an individual in the event of a change in employment. The balance left in the account at the end of the year rolls over, tax-free. Governor Bush and Lt. Governor Jennings believe that HSAs empower patients to be good stewards of their health care dollars. Under this system they have every reason to demand fair pricing; and they have the peace of mind that they will be covered by insurance in any unforeseen catastrophe, such as an accident or sudden illness.
• Transparency: The Bush/Jennings administration recognizes that patients need access to informative, easy-to-understand comparisons between health care providers in order to make competent decisions about health care. Currently, data comparing quality and cost among hospitals and doctors is limited. Governor Bush and Lt. Governor Jennings propose transparency in pricing, cost and quality measures related to health care services so that patients can make comparisons of hospital and other health care provider charges, costs and outcomes - particularly for high volume and elective procedures. In addition to these technology-enabled improvements, the Governor and Lt. Governor propose eliminating the rating adjustment for health status or claims experience that was added to the state’s small employer rating regulations several years ago. This change will permit small employers to better evaluate and compare coverage proposals from competing small employer carriers, and will provide employers and patients with more certainty about their pricing.

Increasing Access to Quality Health Plans

• Maximize our KidCare Resources: The Bush/Jennings administration recognizes that patients need access to informative, easy-to-understand comparisons between health care providers in order to make competent decisions about health care. Currently, data comparing quality and cost among hospitals and doctors is limited. Governor Bush and Lt. Governor Jennings propose transparency in pricing, cost and quality measures related to health care services so that patients can make comparisons of hospital and other health care provider charges, costs and outcomes - particularly for high volume and elective procedures. In addition to these technology-enabled improvements, the Governor and Lt. Governor propose eliminating the rating adjustment for health status or claims experience that was added to the state’s small employer rating regulations several years ago. This change will permit small employers to better evaluate and compare coverage proposals from competing small employer carriers, and will provide employers and patients with more certainty about their pricing.
• Allow Statewide Expansion of Health Flex Plans and Other Local Initiatives: Governor Bush proposes expanding the Health Flex pilot program so that there is statewide access. Health Flex plans permit health insurers, health maintenance organizations, local governments and other public or private community-based organizations to offer alternative health care coverage products to uninsured Floridians. The program is available to those at or below twice the poverty level who are not Medicaid eligible. During its pilot stage, the state limited the availability of these plans to regions of the state with the highest uninsured population. Currently, two Health Flex plans are operating in Miami-Dade County and one is scheduled to begin providing services in Duval County beginning February 1, 2004. In recent months a great deal of interest has been expressed from potential Health Flex providers in areas of the state not included in the pilot. These groups include the Winter Park Health Foundation, the Osceola Chamber of Commerce, Partnership for a Healthier Pinellas, and Citrus Health Plan.
• Pooled Purchasing for Small Employers: Currently, small businesses are at a disadvantage when it comes to providing affordable health care policies to their employees. The Governor proposes allowing small businesses (up to 25 employees) to pool together and leverage their purchasing power. When small employers team up, they spread costs over a wider pool of workers, which expands the availability of affordable health care coverage.
• Creation of a new alternative health insurance market: Governor Bush believes that an active alternative market for health coverage can help stabilize Florida’s health insurance prices, and make them more affordable. He proposes the creation of a program for uninsurable Floridians and those in the single group market. A three-person team will be appointed by the Governor to create the program. This team will be headed by the director of the Office of Insurance Regulation and will examine years of experience, success and failure across 43 states, including Florida’s previous experience with the alternative market. A board of directors will run the program once it is established. The board will determine the actuarial cost and the revenue source. Any funding must be vested in an actuarially sound methodology that provides measurable benefits to the small group insurance market and must yield savings to consumers in the small group market - specifically the savings must translate to lower premiums for employers and their employees.