1. 2009-10 Department of Health LIP Request
Florida Department of Health Low Income Pool Primary Care/Hospital Diversion Projects
Florida Hospital Association Readmission Webinar
February 18, 2010

2. 2009-10 Department of Health LIP Request
Low Income Pool
$1 billion Medicaid Reform program
94% of pool distributed to hospitals

3. 2009-10 Department of Health LIP Request
LIP Council
24 members
Provides pool $ distribution recommendations to Legislature

4. 2009-10 Department of Health LIP Request
LIP “Non-hospital Projects”
$51.3 million for current state fiscal year
$3.2 mil – Poison Control
$18.3 mil – FQHCs
$16.1 mil – Premium Assistance
$1.2 mil – ER Diversion
$3.0 mil – Hospital Primary Care
$9.5 mil – DOH Primary Care/Diversion

5. 2009-10 Department of Health LIP Request
LIP Primary Care Funding History
SFY $2.0 mil
6 projects
SFY $3.0 mil
7 projects
SFY $6.5 mil
11 projects
SFY $9.5 mil
13 projects

6. 2009-10 Department of Health LIP Request

7. 2009-10 Department of Health LIP Request
Project Goals
ED Diversion
Primary Care Medical Home
Chronic Disease Management Services
Link uninsured persons to health coverage

8. 2009-10 Department of Health LIP Request
Project Components
Hospital based navigators or formal referral arrangements with hospitals
Expanded primary care clinic capacity and operating hours
Trained chronic disease management case managers and educators

9. 2009-10 Department of Health LIP Request
Project Components
Pharmacy assistance services
Linkages to specialists through We Care Networks or other volunteer provider organizations
Eligibility assistance staff

10. 2009-10 Department of Health LIP Request
Project Statewide Summary Statistics
January 1, 2009 through June 30, 2009
Emergency Room Diversions
5,683
Emergency Room and Hospital Referrals
5,593
LIP Patients Provided with a Medical Home
11,415
LIP Patients Enrolled in Disease Management Programs
2,259

11. 2009-10 Department of Health LIP Request
Key Project Successes
High proportion of LIP project referrals are enrolled in a primary care medical home and return for subsequent health care services
Patients have much improved access to needed and appropriate health care services
Significant expansion of disease management capacity and improved health status of enrollees
Excellent utilization of pharmacy assistance programs that help reduce hospital re-admissions

12. 2009-10 Department of Health LIP Request
Project Challenges
Meeting the need for basic clinical primary care – demand is greatly challenging supply
Providing timely access to specialty services
Complexity of the chronic disease clients
Transient nature of the targeted population

13. 2009-10 Department of Health LIP Request
Project Challenges
Educating the target population on the concept of a primary care medical home
Hiring physicians and nurses at state pay scales
Partnerships can be a double-edged sword – usually a great asset but sometimes a liability

14. 2009-10 Department of Health LIP Request
To Where from Here?
Recommend expansion of primary care/disease management projects
Develop more direct partnerships with hospitals
Use primary care/chronic disease management programs to help reduce hospital readmissions

15. 2009-10 Department of Health LIP Request
Questions?