Partnership to Improve Care Access for Florida Medicaid Beneficiaries

A value-based agreement between Sunshine Health and Johns Hopkins All Children’s Hospital aims to provide Florida Medicaid beneficiaries with improved access to primary care and incentivize enhanced outcomes through further provider reimbursement.

Sunshine Health, a Medicaid managed care organization, is one of the largest healthcare plans in Florida. The organization had a previously existing relationship with Johns Hopkins All Children’s Hospital, and now, a new two-year agreement aims to provide 56,000 Medicaid members with further access to care.

"This new value-based agreement with a premiere Children's Hospital is consistent with our efforts to further align the goals of Florida's Medicaid Managed Care program with the goals for our valued providers," said Nathan Landsbaum, president and CEO of Sunshine Health, in a press release. "We are honored to continue our partnership with Johns Hopkins and look forward to delivering better health outcomes for our members and the state of Florida."

Johns Hopkins All Children’s Hospital is a clinical and academic health system providing healthcare to infants, children, and teenagers. Through the expanded partnership with Sunshine Health, over 40 practices comprised of 160 primary care providers in the clinically integrated All Children’s Care Network (ACCN) can receive higher reimbursement. This will be tied to physicians working with Sunshine Health members to improve outcomes and provide care related to prevention and maintenance.

We Care Pediatrics, East Lake Pediatrics, Tarpon Springs Pediatrics, Partners in Pediatrics, and Ocean Pediatric Care are among the many practices involved in the partnership.

Many efforts reflect the ongoing goal of providing Medicaid and Medicare beneficiaries with expanded access to care.

In April, the US Department of Health and Human Services released guidance to assist states in increasing access to healthcare for incarcerated Medicaid beneficiaries.

Released by the Centers for Medicare and Medicaid Services (CMS), this guidance, known as the Medicaid Reentry Section 1115 Demonstration Opportunity, provides state Medicaid programs with the ability to cover healthcare services for up to 90 days prior to the release date of an incarcerated patient.

Additionally, in May, Humana began a partnership with Longevity Health Plan to improve specialty needs plan benefits for Medicare Advantage members.

This effort focused on enhancing care for patients in skilled nursing facilities and senior living homes. Those involved in the collaboration aimed to assist patients with multiple complex conditions through value-based contracts with operators.

“These individuals have unique care needs, and this expands our ability to offer them the best care possible in a way that is better for the member’s health and in an environment that is more engaging and comfortable for their loved ones,” said George Renaudin, president of Medicare and Medicaid at Humana, in a press release.