When considering Medicaid reform initiatives, it is important to consider the dramatic, often negative, effects reforms can have on the emergency care safety net for the population of Florida.

Medicaid reforms should seek to protect access to emergency care for all who need it while at the same time promoting fiscal responsibility and the provision of quality care.

Key points to stress:

1. The negative impact of provider rate cuts have resulted in fewer providers accepting Medicaid patients and forcing more patients to seek costlier care in the emergency department. This becomes an access-to-care issue for Medicaid patients and winds up increasing health care costs.
2. Reducing provider rates to hospitals and physicians who provide emergency care in the emergency department would jeopardize the Medicaid patient population access to emergency care when it is needed.
3. Tightening eligibility requirements to reduce the size of the Medicaid patient population simply forces more people into the ranks of the uninsured, impacting their access to care and resulting in increased uncompensated care that puts a significant strain on emergency departments, hospitals, and the state.
4. Investing in increasing the alternate sites of care for non-emergency Medicaid patients (for example by increasing hospital clinics, outpatient clinics, or doctor office hours) would result in a more efficient utilization of healthcare dollars and help to decrease non-emergent, expensive emergency department usage by the Medicaid patients who have no other site to obtain primary care. This initial upfront investment would pay off in decreased overall costs in the long run. This concept would also promote more preventive care in the Medicaid population, leading to higher quality of care and lower costs to the healthcare system.