TGH joins state program to trim Medicaid costs

Tampa General links with another hospital, the state and Pfizer in a venture intended to save millions.

By WES ALLISON, Times Staff Writer
© St. Petersburg Times
published March 13, 2002

TAMPA -- Tampa General Hospital plans to enroll 1,200 area Medicaid patients in a new state program with Pfizer Inc. that is designed to save taxpayer money while giving the pharmaceutical giant a chance to earn more state business.

Tampa General and Jackson Memorial Hospital in Miami are the first of up to 10 Florida hospitals to participate in the new program, which is called Florida: A Healthy State.

Under the contract signed with the state Agency for Health Care Administration last spring, Pfizer's medications will be put on the list of approved drugs for Medicaid patients, but not at the deep discounts usually required to get on that list.

In return, Pfizer has pledged to save the Medicaid program $33-million over the next two years. If it doesn't, the company must pay the difference in cash.

The company says the savings will come from providing health education to Florida Medicaid patients with three chronic illnesses: diabetes, asthma and high blood pressure.

Teaching these patients to care for themselves and manage their diseases -- from diet and exercise to regular office exams -- will reduce expensive emergency room visits, state and Pfizer officials said. Eventually, up to 50,000 patients statewide could go through the program.

Florida has about 1.5-million recipients of Medicaid, the state-run insurance program for the poor that pays for virtually all drugs and medical care.

"Care managers will be working with the patients by phone -- we'll go out to their homes if that's indicated," said Candace Billingsley, director of outcomes management at Tampa General. "By having care managers work with these high-risk patients, it's less likely that they will end up in a medical crisis."

Billingsley said about 300 patients have been enrolled, and services have begun for 132. Tampa General spokesman John Dunn said the hospital has hired six care managers, a program manager, project director and medical director to work one-on-one with 1,200 Medicaid patients in Hillsborough and Pinellas counties. Pfizer provided the money through the state.

Pfizer also will provide free drugs in some cases and set up toll-free hotlines to answer health questions from patients.

The agreement was struck in private in the winter of 2000 and 2001. When it was disclosed during last year's legislative session, critics accused the Bush administration of crafting a secret sweetheart deal for Pfizer. Pfizer and state health officials said the company was not given preferential treatment.

But the contract also led to a new state law that exempts information about similar deals from having to be disclosed under Florida's public records law.

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