Evaluation of Florida’s

Contract MED180

Evaluation of Florida's Managed Medical Assistance (MMA) Program Demonstration: Project 2 Final Interim Report

Contract Deliverable No. 21, Managed Medical Assistance Final Interim Report ? Project 2 SFY 2016-2017 (DY11): Component 3,

Healthy Behaviors

Presented to:

Prepared by: Department of Health Outcomes and Biomedical Informatics

College of Medicine University of Florida

and Department of Behavioral Sciences and Social Medicine

College of Medicine Florida State University

March 27, 2020

Table of Contents

Executive Summary ...................................................................................................... 1 Overview................................................................................................................................... 1 Key Findings ............................................................................................................................ 2

Introduction ................................................................................................................... 4

Background ................................................................................................................... 4

Component 3 Evaluation Questions and Hypotheses ............................................... 6 Research Questions ................................................................................................................ 6

Data and Methods ......................................................................................................... 7

Results ........................................................................................................................... 7 Research Question 3A............................................................................................................ 7 Research Question 3B............................................................................................................ 9 Research Question 3C............................................................................................................ 9 Research Question 3D...........................................................................................................12 Research Question 3E...........................................................................................................16

Conclusion and Recommendations .......................................................................... 17

Appendix. DY11 MMA Evaluation Components and Research Questions............. 18

List of Tables

Table 1. Number of Healthy Behaviors Programs and Incentive Types .........................................................................7 Table 2. Enrollee Participation and Completion Rates in Healthy Behaviors Programs ..............................................11 Table 3. Enrollee Participation and Completion Rates in Healthy Behavior Programs by Gender...............................13 Table 4. Enrollee Participation and Completion Rates in Healthy Behaviors Programs by Age ..................................15

List of Acronyms

Agency CDPS CHCU CMS CY DY EBAP ER FS HB LIP LTC MMA OTC PMPM SFY SMMC STC UF

Agency for Health Care Administration Chronic Illness and Disability Payment Child Health Checkup Centers for Medicare and Medicaid Services Calendar Year Demonstration Year Enhanced Benefits Account Program Emergency Room Florida Statutes Healthy Behaviors Low Income Pool Long-term Care Managed Medical Assistance Over-the-Counter Per Member Per Month State Fiscal Year Statewide Medicaid Managed Care Special Terms and Conditions University of Florida

Executive Summary

Overview

This report presents the interim results of Project 2 of the Statewide Medicaid Managed Care (SMMC) Managed Medical Assistance (MMA) Program Evaluation for Demonstration Year 11 (DY11), State Fiscal Year 2016-17 (SFY 2016-17), the third year of the MMA program. Project 2 focuses on Component 3 of the evaluation, which examines the Healthy Behaviors programs, the voluntary rewards programs developed and implemented by participating MMA health plans.

The MMA plans offer a variety of Healthy Behaviors initiatives in addition to the three Agencymandated programs. At a minimum, each managed care plan must establish a medically approved smoking cessation program, a medically directed weight loss program, and a medically approved alcohol or substance abuse recovery program. The managed care plans must identify enrollees who smoke, are morbidly obese, or are diagnosed with alcohol or substance abuse and establish written agreements to secure the enrollees' commitment to participate in the following programs:

(1) A medically approved smoking cessation program that is evidence-based and recognized by medical professionals as an effective treatment method in addressing tobacco/nicotine dependence. The program may include interventions such as counseling and/or the use of medications (nicotine replacement products) as a part of the overall therapeutic process.

(2) A medically directed weight loss program that requires ongoing supervision by a physician and may include the use of prescription drugs/supplements depending upon the need and goals of the enrollee, along with other physician-approved interventions (diet, exercise, etc.).

(3) A medically approved alcohol or substance abuse recovery program that is evidencebased and recognized by medical professionals as an effective treatment method/approach. The program may include interventions such as medically assisted detoxification, medication and behavioral therapy, followed by treatment and relapse prevention as a part of the overall therapeutic process.

Some of the optional programs include incentives for engaging in preventive care, cancer screening, and prenatal and postpartum care. Retail gift cards or points that can be converted into a monetary value are common incentives across the health plans.

The results in this report were based on the review and analysis of quarterly and summary reports of the Healthy Behaviors programs for each plan. Aggregate descriptive statistics were calculated based on these reports.

Prepared by:

1

Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida

Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University

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