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Plan Taps Medical Residents To Treat Medicaid Patients

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By CATHERINE DOLINSKI

cdolinski@tampatrib.com

Published: April 2, 2009

TALLAHASSEE - Rep. Ed Homan of Tampa rolled out a plan Wednesday that he said would expand Florida's thinning ranks of doctors while improving care of local Medicaid patients.

Homan heads the House's Health and Family Services Policy Council, which on Wednesday approved his proposal for a pilot project to send Medicaid patients in Hillsborough and Alachua counties to federally funded nonprofit health clinics for regular primary care and to local medical schools for specialty treatment.

In the Tampa Bay area, that would mean sending poor and disabled Medicaid participants for specialty care to licensed medical residents at the University of South Florida. Alachua County participants would receive such care from University of Florida licensed medical residents. Patients could opt out of participating by choosing a different option for care such as a Medicaid HMO.

Homan said he wants to create a "medical home" for poor patients, steering them to preventive and primary care and away from pricey emergency rooms. Meanwhile, sending those patients to medical schools for specialty treatment would expand the state's residency programs, which Florida desperately needs to grow its ranks of doctors, he said.

Physician survey data over several years show that more doctors are moving away from the state than to it, Homan said. Thirty-one percent of Florida-licensed physicians don't even live in Florida, 26 percent are 65 or older, and 23 percent work only part time.

"In another five years or so, when our older physicians retire, we're going to have a serious access problem," Homan said.

Florida's medical school deans support Homan's idea, but it faces challenges, particularly in the Senate, where Homan has yet to find a co-sponsor. In the House, the bill passed Homan's panel only after he agreed to leave out several counties.

And health maintenance organizations, which treat many of Florida's 2.5 million Medicaid patients and are heavily involved in an existing Medicaid pilot project, oppose Homan's idea.

"We believe this is extending a new Medicaid reform initiative out there at this time when we're still trying to figure out the problems of the first one," said Michael Garner, president of the Florida Association of Health Plans.

Though a critic of that Medicaid Reform project, begun under former Gov. Jeb Bush, Homan insisted he is not introducing his program to replace that one. "This is not Medicaid reform 2," he said.

Reporter Catherine Dolinski can be reached at (850) 222-8382.

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