The growth in Medicaid spending in Florida over the past 12 years was five times the growth of state revenues. If Medicaid continues to grow at this rate, it will bankrupt our state. And because Florida is facing a budget shortfall a choice has to be made between funding other priorities like education and continuing to give more funds to hospitals.

Changing the way Medicaid hospital providers are reimbursed is the most logical first step to address this problem because hospital costs make up 22 percent of all Medicaid spending, and the current system for reimbursing Medicaid hospital providers is unfair, illogical and inefficient.

Hospitals around the state are being reimbursed at different rates for providing the same services. Some hospitals are also able to spend local tax dollars to qualify for even more government money in the form of higher Medicaid reimbursement rates.

This isn’t only unfair to the hospitals that aren’t able to take advantage of that loophole, but to the taxpayers who foot the bill as well. These inconsistencies have resulted in a system that discourages efficiency, wastes taxpayer money and creates unpredictable costs for the state.

For example, in Miami-Dade County, 13 similar general acute hospitals receive reimbursement for inpatient care ranging from $603 to $1,794 for one day. Similar hospitals in Broward County have inpatient care rates ranging from $451 to $2,399. To create a more fair Medicaid reimbursement methodology, Gov. Rick Scott has proposed setting a flat rate for similar hospital groups performing similar services. This flat rate is the first step toward stabilizing the market, reining in the cost of hospital care and allowing more money to be spent on education.

Under the current system, a hospital receives money based on the Medicaid reimbursement rate for one day of care, regardless of what care is provided. So taxpayers pay the same amount whether a person is treated for a relatively minor injury, such as a sprained ankle, or for a major medical emergency, such as a heart attack. Our goal is to eventually move toward a payment system where the reimbursement cost reflects the care the patient receives.

Clearly a solution is needed. We look forward to working with the Legislature and hospitals to implement the governor’s proposal to improve Florida’s Medicaid reimbursement methodology and increase the amount of money available for education.

Liz Dudek, secretary, Agency for Health Care Administration, Tallahassee