ORLANDO, Fla.-Orlando Regional Healthcare System and Aetna Health Plans of Florida have signed an agreement to share risk in a new managed-care product. "Orlando Regional will be responsible for the medical cost elements of hospital inpatient, outpatient, emergency, home health and all specialists, and we will be responsible for the primary gatekeepers," said James Gilmour, Aetna's executive director in Tampa. Aetna Health Plans of Florida enrolls 18,000 members in the Tampa area, but Mr. Gilmour said marketing efforts soon will begin in Orlando. Pending state approval, plans also call for Aetna to bid for contracts with Orlando Regional in the state's managed-competition system, Mr. Gilmour said. He said about 100 primary-care physicians have been offered contracts for the new managed-care product. Mr. Gilmour declined to state how much risk each organization would assume, but he did say it wasn't 50-50.
TALLAHASSEE, Fla.-Gov. Lawton Chiles has proposed providing discounted insurance to 1.1 million uninsured state residents in his Florida Health Security Program. The program, which must be approved by the state Legislature and federal government, could begin on July 1, a state spokesman said. Under the plan, a family of four with household income of $35,875 or less could pay from $9 to $18 per month for a basic benefit package. Private insurance would be purchased through the state's 11 community health purchasing alliances, or Chippas. The bulk of the premiums, which would run an average of $331 for a family of four, would be picked up by the state and federal government through Medicaid funds. The state is expected to submit a waiver to the federal government later this month to allow it to use an estimated $54 million in Medicaid funds for the program. "This won't cost the state or federal government a nickel," said Ed Towey, a state spokesman. "The funding will come from money saved by putting Medicaid people into managed care." Mr. Towey said Florida saved $45 million in 1993 by enrolling about 190,000 of 1.4 million Medicaid recipients in HMOs.