MEDICAID EXPENDITURES

The information in the Florida Medicaid Expenditures by Provider Category table shows total Medicaid expenditures for some of the larger Medicaid service provider categories along with the number of beneficiaries served. The average cost per beneficiary is provided for each service listed. An unduplicated total of beneficiaries served is used to show the average cost per beneficiary for the Medicaid services in the state fiscal year. There are beneficiaries that use services from more than one provider category in a given state fiscal year.

For many of the provider categories, you can click on the category to get to the detailed expenditure paid for each Provider. The total amounts on the detail sheets may not match the Provider Category table due to adjustments that were paid to the provider. Examples of adjustments may be retroactive changes in payment rates. These adjustments are not paid at the individual beneficiary level. Included in these provider categories are providers that qualify and receive payments through the Low Income Pool (LIP) and the Disproportionate Share Hospital (DSH) programs.

The Low Income Pool (LIP) was established as an element of Florida’s 1115 Research and Demonstration Waiver related to Medicaid reform, effective July 1, 2006. LIP was to ensure continued government support for the provision of health care services to Medicaid, underinsured and uninsured populations. LIP consists of a capped annual allotment of $1 billion total computable for each year of the 5 year demonstration period. The parameters of LIP are defined in the Waiver’s Special Terms and Conditions 91 through 106.

The Disproportionate Share Hospital (DSH) program as defined in ss. 409.911-409.9118, F.S. was created to compensate hospitals that provided a disproportionate share of Medicaid and/or charity care services. Although the programs exist in statute, legislative funding is required every year in order to enable the Agency to distribute payments.

The table is created based on the most recent fiscal year for which Medicaid expenditure information is available. For Florida Medicaid Expenditures, Fiscal Year 2006-2007, click here.

Provider Category	Total Amount Paid	Beneficiaries Served	Average Per Beneficiary
Nursing Home Care	$2,340,673,457	68,051	$34,395.87
Hospital Inpatient Services	$2,029,727,548	226,559	$8,958.94
Prepaid Health Plans	$1,948,076,072	1,162,626	$1,675.58
Prescribed Medicine/Drugs & Part D	$1,427,032,684	1,556,586	$916.77
Home & Community Based Services	$1,105,290,145	109,738	$10,072.08
Supplemental Medical Insurance	$881,892,548	574,666	$1,534.62
Physician Services	$629,632,223	1,087,066	$579.20
Hospital Outpatient Services	$499,042,394	640,278	$779.42
Hospice Services	$278,307,135	18,078	$15,394.80
Intermediate Care Facilities - Community	$235,935,662	2,201	$107,194.76
Nursing Home Diversion	$237,625,279	13,007	$18,269.03
Home Health Services	$158,960,962	118,667	$1,339.55
Intermediate Care Facilities - Sunland Centers	$94,414,600	829	$113,889.75
County Health Departments	$102,022,549	203,215	$502.04
Rural Health Clinics/Federally Qualified Health Centers	$75,016,508	176,497	$425.03
Low Income Pool	$993,647,961	N/A	N/A
Hospital Disproportionate Share	$278,969,491	N/A	N/A
Other	$1,486,572,590	1,786,909	$831.92
Total	$14,802,839,808	N/A	N/A
Unduplicated Total Beneficiaries and Average per Beneficiary	$14,802,839,808	2,626,870	$5,635.16