The Agency for Health Care Administration (Agency) today announced that based on the Urban Institute’s report on Medicaid/CHIP Participation Rates, Florida’s Medicaid program showed significant improvement in the percentage of eligible children enrolled in the Medicaid and Children’s Health Insurance (CHIP) programs. Florida saw a 7.1 percentage point increase in eligible children enrolled in the Florida Medicaid and CHIP between 2013 and 2015. This represents the sixth highest state increase in the nation, and is well above the national average increase. To access the full report click here.
Agency Secretary Justin M. Senior said, “With the implementation of Statewide Medicaid Managed Care our state has revolutionized the way we administer the Medicaid program. This report highlights that more children than ever are receiving health care services and have access to the highest quality of care in our program’s history. With the increased percentage of eligible children enrolled in the Medicaid program, and the improvement in access to services announced this spring as part of the CMS-416 report, the numbers are proving that our program is a success and that children are receiving necessary health care. We know we have more work to do, but our managed care system continues to improve each year — the proof is in the numbers, and our Agency will remain committed to our goal of better health care for all Floridians.”
The CMS-416 report announced last month showed that Florida Medicaid continues to improve in children’s access to health care services. For the second year in a row, Florida showed gains in every single metric in the 416 report. The 2016 CMS-416 data reported to the Centers for Medicare & Medicaid Services (CMS) is a nationally recognized quality and access measure in the Medicaid program, and includes a yearly report that tracks the number of children who received preventive medical screening and dental services. The Agency also saw improvements in children receiving blood lead screenings and the usage of dental and other oral health services. Florida’s dental scores have improved every year since 2011.
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AHCA announces continued improvements in access to health care services for children
The Agency for Health Care Administration (Agency) announced today that Florida’s Medicaid program showed significant improvement in a key national report on quality and access for children. The report showed continued improvement in children’s access to services for the second year in a row, with Florida once again showing gains in every single metric in the report. The 2016 Form 416 data reported to the Centers for Medicare & Medicaid Services (CMS) is a nationally recognized quality and access measure in the Medicaid program, and includes a yearly report that tracks the number of children who received preventive screening and dental services. The Agency saw improvements in children receiving blood lead screenings and the usage of dental and other oral health services, and Florida’s dental scores have improved every year since 2011.
Agency Secretary Justin M. Senior said, “The Agency has worked to improve quality and access simultaneously, and the increase in usage of Medicaid services by eligible children is a testament to the hard work that our Agency has done. Preventive services are vital for keeping Florida’s children healthy, and I am excited that we are delivering necessary health care to more eligible children than ever. Our managed care system is working as it was intended to, and we will continue to work to ensure that all Medicaid recipients have access to quality health care.”
During this reporting period, 36 percent of eligible children enrolled for 90 continuous days received a preventive dental service, such as dental cleanings and fluoride varnish, as calculated using the Child Core Set P-Dent measure. This is an increase of 3 percentage points from last year and 17 percentage points from the federal fiscal year 2012 report. In addition, this year 156,291 children received a sealant on a permanent molar, an increase of more than 16,550 children (12 percent) compared to last year. Over the reporting period, 38 percent of eligible enrollees accessed dental services provided by a dentist, an increase of 3 percentage points, and more than 41 percent of eligible enrollees accessed some form of oral health care through Medicaid. These dental scores are the highest in the history of the program. In addition, the ratio for eligible enrollees receiving an initial or periodic screening increased from 0.57 to 0.59. The Agency also achieved a 5.4 percent increase in children who were tested for lead in their blood.
States are required by CMS to inform all Medicaid-eligible individuals under the age of 21 of the availability of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, provide or arrange for the provision of screening services, arrange for necessary corrective treatment and annually report EPSDT performance information via Form CMS-416. For more information on the Agency’s Medicaid program, visit the Medicaid website at: http://ahca.myflorida.com/Medicaid/index.shtml
Being rude to your child’s doctor could lead to worse care
Emotions tend to run high in hospitals, and patients or patients’ loved ones can be rude to medical professionals when they perceive inadequate care.
But berating your child’s doctor could have harmful — even deadly — consequences, according to new research.
The findings by University of Florida management professor Amir Erez and doctoral student Trevor Foulk reinforce their prior research that rudeness has “devastating effects on medical performance,” Erez said.
A Johns Hopkins study estimated that more than 250,000 deaths are attributed to medical errors in the U.S. annually—which would rank as the third-leading cause of death in the U.S., according to statistics from the Centers for Disease Control and Prevention.
Some errors could be explained by a doctor’s poor judgment due to a chronic lack of sleep. Those types of circumstances, according to prior research from Erez and Foulk, account for about 10 to 20 percent of the variance in practitioner performance.
The effects of rudeness, Erez said, account for more than 40 percent.
“[Rudeness] is actually affecting the cognitive system, which directly affects your ability to perform,” Erez said. “That tells us something very interesting. People may think that doctors should just ‘get over’ the insult and continue doing their job. However, the study shows that even if doctors have the best intentions in mind, as they usually do, they cannot get over rudeness because it interferes with their cognitive functioning without an ability to control it.”
In a previous study, Erez and Foulk examined the effects of rudeness from a colleague or authority figure on individual medical professionals. This study analyzed team performance and the effects rudeness has when it comes from a patient’s family member.
In the new study, 39 neonatal intensive care unit teams (two doctors and two nurses) from Israel simulated five scenarios where they treated infant medical mannequins for emergency situations such as severe respiratory distress or hypovolemic shock. An actress playing the baby’s mother scolded certain teams while the control groups experienced no rudeness.
Erez and Foulk found that the teams that experienced rudeness performed poorly compared to the control groups. The teams that encountered rudeness were deficient in all 11 of the study’s measures, including diagnostic accuracy, information sharing, therapy plan, and communication, over the course of all five scenarios showing that the negative effects last the entire day.
To combat the effect of rudeness, the researchers included “interventions” for selected teams. Some teams participated in a pre-test intervention which consisted of a computer game based on a cognitive-behavioral attention modification method intended to raise the threshold of the participants’ sensitivities to anger and aggression. Other teams participated in the post-test intervention, which consisted of team members writing about the day’s experience from the perspective of the baby’s mother.
Erez and Foulk found no difference in the performances of the control groups and the teams that played the computer game. The teams recognized the mother’s rudeness —both midway and after the simulation — but were not affected by it.
“It’s really shocking how well it worked,” Erez said. “They were basically immunized from the effects of rudeness.”
Conversely, the post-test intervention, which research has shown to be extremely successful for victims of trauma, actually had a negative effect on teams.
“What is really concerning is that, at midday, these teams recognized the mother was rude to them,” Erez said. “But at the end of the day, they did not. So not only did it not work, but it caused them to not recognize rudeness later.”
Considering the researchers’ findings and the large number of deaths attributed to medical errors, teaching medical professionals to handle rudeness more effectively should be a priority for the medical community.
“In the medical field, I don’t think they take into account how social interactions affect them,” said Erez, “but it’s something they’re starting to pay attention to. The purpose of this research was to identify what’s going on here. Now that we’ve found serious effects, we need to find more realistic interventions.”
Dr. Arik Riskin, a professor of Neonatology at the Technion, Israel Institute of technology, and Peter Bamberger, a professor of management at Tel Aviv University in Israel, also collaborated on this research. The study, “Rudeness and Medical Team Performance,” appears in the January issue of Pediatrics.
Writer: Milenko Martinovich
Source: Amir Erez, [email protected], 352-273-0339
