Lighthouse Health Plan Celebrates Successful

First Year of Operations as Provider Sponsored Network

Open House Planned for Tuesday, January 28, 2020, 10 a.m. to 11 a.m.

On February 1, 2019, Lighthouse officially launched a new, local way of thinking about Medicaid health care and the role of health plans in our communities. As a doctor-led Medicaid health plan based in the Florida Panhandle, Lighthouse has grown by 17 percent, from 25,574 to 30,021 members in its first year.

In the Florida Panhandle’s 18 counties that comprise Medicaid Regions 1 and 2, more than 70 percent of the people who qualify for Medicaid are children. Many of these children face food and housing insecurities and social and economic disadvantages, creating challenges to receiving basic health care. Within Lighthouse specific member rolls reflect more than 80 percent are children.

“The biggest challenge we have faced in our first year had to do with issues facing children and moms – low birth weight and premature births, ensuring our members make their well-child visits, adults get annual check-ups, and members have access to the right care at the right time,” said Christie Spencer, CEO, Lighthouse Health Plan.

Lighthouse’s one-on-one care management programs have helped educate high-risk members on issues such as how to have a healthy pregnancy, substance abuse, and even connecting members to valuable community resources that go beyond the doctor’s office. Its partnerships with providers that offer extended office hours and urgent care has helped decrease the reliance on costly emergency room visits for minor illnesses.

“Since we live and work in a large rural area, our transportation and telemedicine offerings have been two major keys to a successful first year. Transportation to doctor appointments and the pharmacy is free for our members. Telemedicine is new, but it’s catching on fast. It helps bring specialists to patients virtually, as well as resolve simple medical issues without requiring a member to travel long distances to see a doctor,” Spencer furthered.

In October, Lighthouse added new expanded benefits, free services for members that goes above and beyond what the state of Florida requires from a Medicaid plan. Some of these expanded benefits are swimming lessons for children, housing assistance, extra chiropractic visits, equine and art therapy for adults, and acupuncture.

“One exciting aspect of being a community-based Medicaid plan has been our partnerships with local agencies in sponsoring and becoming involved with a variety of projects and events that reach out to the larger community,” added Spencer. “Whether it is a bike ride to help provide children with their own bikes or collecting toiletries for teens, our team remains committed to Northwest Florida.”

Another example is Lighthouse’s partnership in the upcoming Achieve Healthy EscaRosa datawalk on February 20, 2020 at the UWF Conference Center. Representatives from local hospitals, the Department of Health, Community Health of Northwest Florida, the University of West Florida, Lighthouse Health Plan and other community organizations have partnered to take a deep dive look into key health and wellness findings in Escambia and Santa Rosa counties.

Lighthouse Health Plan is a local, community-based health plan created and run by doctors. Lighthouse will serve Escambia, Okaloosa, Santa Rosa and Walton counties in Medicaid Region 1 of Florida; and Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, and Washington counties in Medicaid Region 2 as a Provider Service Network (PSN).

The PSN plan was created by Florida state legislature in 1997 when the Legislature authorized the Florida Medicaid program to establish a Medicaid PSN demonstration project to capitalize on high-volume Medicaid providers and their ability to manage the medical care of Medicaid beneficiaries they serve. “Provider Service Network” means an entity qualified pursuant to s.409.912(2) of which a controlling interest is owned by a health care provider, or group of affiliated providers, or a public agency or entity that delivers health services. Health care providers include Florida-licensed health care professionals or licensed health care facilities, federally qualified health care centers, and home health care agencies.