HOSPITAL UTILIZATION: FLORIDA MARKETS RUN COUNTER TO TREND
"Despite having the state's highest HMO enrollments, MiamiThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
and Fort Lauderdale posted the highest hospitalization rates for
people under 65 statewide in 1996," Wall Street Journal/Florida
Journal reports. According to data compiled by the Florida
Hospital Association, Miami averaged 421 patient days per 1,000
people in 1996, the highest rate of hospital unitization in the
state. "Fort Lauderdale was second at 392 patient days per 1,000
last year," Journal reports. The statewide average was 344
patient days per 1,000. Because 45% of Miami's population and
39% of Fort Lauderdale's population are in HMOs, "many health
care experts say they would expect ... the lower hospital
utilization rates seen in other heavily managed care markets in
California and Washington." The overall HMO penetration rate for
Florida is 29.5%. "Clearly there is not as strong a link between
high managed care penetration and low use rates for hospitals. I
thought we would see very low use rates in South Florida," said
Kim Streit, vice president of health care research at the Florida
Hospital Association.
TOO FRAGMENTED?
According to health care experts, there are three main
reasons "why the state's largest HMO markets haven't produced
sharper reductions in hospital use." The first is that the
"South Florida HMO market has more than 20 health plans, making
it more fragmented than the rest of the state and thus limiting
the power of individual HMOs to negotiate terms with hospitals."
The second is that "[p]hysicians in South Florida have been
slower than their counterparts elsewhere in the state to form
large medical groups that enable HMOs and hospitals to better
managed care." And finally, "[p]hysicians and hospitals in South
Florida practice more defensive medicine ... in what is generally
considered a more litigious environment." The Journal also notes
that "[u]nlike in other heavily managed care markets, most HMOs
in South Florida still negotiate daily fees with hospitals,
instead of seeking capitated contracts" (Terhune, 10/29).