Blues plan enters Florida Medicaid market

Blue Cross Blue Shield of Florida (BCBSF) is entering the state's Medicaid market with a joint venture agreement with Philadelphia-based AmeriHealth Mercy Family of Companies, announced last week.

The new Medicaid plan, called Florida True Health, will be an equal partnership between BCBSF and AmeriHealth Mercy, with both insurers sharing in start-up costs, financial risk and risk-based capital. It will enroll Medicaid members, process claims, develop provider networks and manage quality, among other services, reported the Jacksonville Business Journal.

"We looked for a partner that had very strong experience in Medicaid and a good reputation," BCBSF spokesman John Herbkersman said. "That would enable us to hit the ground running from day one."

BCBSF chose to partner with AmeriHealth Mercy instead of building a Medicaid plan entirely on its own because it, like most other Blues plans, has never participated in Medicaid before. And because all Florida Medicaid participants must enroll in an HMO or other narrow network plan next year, the time was right for BCBSF to make a move now.

"This is something we really have to do," Herbkersman told Health News Florida. "We are the largest health care insurer in the state and we feel we should be working to provide the high-quality services that we provide to (current) customers to Floridians who are in need."

Medicaid business consultant Brady Augustine said the BCBSF-AmeriHealth Mercy venture is a "perfect marriage" because of BCBSF's broad base and AmeriHealth Mercy's depth of Medicaid knowledge. "They can be a major player quickly and create competition for the for-profit HMOs," he told Health News Florida.

Florida True Health is expected to open business later this year after state officials approve its application.

To learn more:
- read the Health News Florida article
- check out the Jacksonville Business Journal article

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