Home Health News Medicaid patients have Pensacola-based, doctor-run health care option in Lighthouse Health Plan – Pensacola News Journal

Medicaid patients have Pensacola-based, doctor-run health care option in Lighthouse Health Plan – Pensacola News Journal

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A new community-based health plan created and run by doctors will begin serving Escambia, Santa Rosa and other Panhandle counties next month. 

On Feb. 1, Lighthouse Health Plan will begin serving approximately 24,000 Medicaid patients in 18 Panhandle counties.

Christie Spencer, Lighthouse’s CEO, said the organization’s unique position as a provider sponsored network means it can work hand-in-hand with local agencies and physicians to provide resources and services that are tailored to the local community’s needs.

“We’ve spent a lot of time engaging with the provider community, advocates and community partners in general,” Spencer said. “So now that we have members, our main mission is to get all those people together and everybody have a plan for their health care so that they know what sort of preventative things they need, and also what to do when an adverse events happens.”

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Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. 

Approximately 200,000 people in the Florida Panhandle qualify for Medicaid coverage. about 70 percent of whom are children.  

There are three other Medicaid providers serving the Panhandle, but they are national, commercial entities headquartered outside the communities they serve, Spencer said. She noted when the insurance and delivery segments of health care are separate, it can sometimes cause disconnects that result in bad outcomes.

“We know (providers) could recommend a specialist or recommend a certain treatment, but Medicaid patients don’t always have access to transportation or their schedules are not always stable enough that they can make an appointment two weeks from now,” Spencer said.

She said Lighthouse has a team of community health workers who can help facilitate transportation and provide other services to ensure patients get the help they need.

“We really are an extender of what the doctors want and need, but don’t have the resources to do,” Spencer said.

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Lighthouse is contracted locally with Baptist, Gulf Breeze, Jay and Sacred Heart hospitals, and partners with organizations such as Community Health Northwest Florida. Spencer said something else that makes Lighthouse unique is that it can work with those entities, help supplement their programs and direct patients to existing local resources like diabetes education classes and smoking cessation programs.

“We want to use the programs that are already in the community and add on to them so they are more effective,” Spencer said.

“One of the big resources we can give them is from our predictive modeling … . It takes data from lots of different sources — claims data, population demographics, food deserts — all of this data and really can predict which of our physician’s patients are the ones most likely to have an adverse effect in the next two months.”

Lighthouse is a provider service network, a type of health care provider-managed entity authorized by Florida Legislature in 1997 to more effectively manage the medical care of Medicaid beneficiaries its serves.

Spencer noted an ancillary benefit of having Lighthouse in Pensacola is it will create more than 100 new jobs and generate an estimated $75 million to $80 million in annual revenue. 

Lighthouse’s new headquarters are at 700 E. Gregory St. in Pensacola. The organization will hold a ribbon cutting ceremony Jan. 22.

For more information about Lighthouse Health Plan, visit lighthousehealthplan.com.

Kevin Robinson can be reached at krobinson4@pnj.com and 850-435-8527.

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