Anne Swerlick
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October 15, 2019

Medicaid Managed Care Performance Measures: A Key Tool for Reducing Child Health Disparities and Increasing Transparency and Accountability

Executive Summary

Children of color are disproportionately impacted by poor quality health care. They have higher rates of asthma, obesity and chronic conditions related to trauma exposure. These disparities can have life-long consequences, impacting a child's education, future employment, financial security and their adult health. Disparities also increase the overall cost of health care.

Florida’s Medicaid program can significantly reduce child health disparities. It provides health coverage for a disproportionate share of children of color: 27 percent of Black children and 36 percent of Hispanic children.

Most are served through the Statewide Medicaid Managed Care (SMMC) program. Florida has made a substantial investment in this program — nearly $90 billion for 2018-2023. These dollars flow to mainly private for-profit health plans.

The Florida Agency for Health Care Administration (AHCA) is responsible for oversight of the SMMC program. Performance measures are an important tool AHCA uses to monitor quality of care. These include, for example, percentages of children receiving developmental screenings, preventive dental care, well-child check-ups and childhood immunizations.

Florida has made substantial progress over the past few years in improving Medicaid quality of care. However, children of color are at risk of not benefiting from this progress. Moreover, the state still ranks well below the national average on multiple key child health performance measures. Children of color are likely to be faring even worse on these measures than their white counterparts.

Data that would identify and assess these differences is not currently available or publicly reported. AHCA does not collect or report on health plan performance measures, including child health measures, stratified by race, ethnicity and primary language. Experts agree that this information is essential for identifying differences in care and developing targeted interventions needed to reduce health disparities.

Florida law should be amended to require AHCA to collect and publish this information. Not only is this critical for combating child health disparities, but it's also essential to promoting transparency and accountability in the program, as well as fulfilling the Legislature's oversight duties and stewardship of billions of dollars of public funding.

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