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Gables Entrepreneur’s New Healthcare Venture

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CBS Miami (con't)

Affordable Care Act Updates: CBSMiami.com/ACA

Health News & Information: CBSMiami.com/Health

MIAMI (CBS4) -Coral Gables medical entrepreneur Miguel “Mike” Fernandez announced a plan on Wednesday to invest up to $100 million statewide to take advantage of new Medicaid changes proposed by Governor Rick Scott, according to CBS4 news partners The Miami Herald.

To get it done, Fernandez plans to form an alliance with Miami Children’s Hospital to build up a series of provider service networks, or PSNs, which operate much like HMOs but are majority owned by doctors and hospitals that participate.

Dubbed Miami Children’s Better Health, the PSN is for Medicaid children and their parents in Miami-Dade County. It will consist of a network that will start with the 160 doctors at Miami Children’s Hospital and will expand to include other doctors and hospitals in the county, Fernandez explained. Plans to expand statewide are also in the works, with networks proposed in Orlando, Jacksonville, Tampa and the Panhandle.

PSNs have been encouraged by interim secretary of the Florida Agency for Health Care Administration Elizabeth Dudek. It was she, Fernandez says, who “planted the seed” for the idea allowing the sides to join forces.

“Historically there has been an adverse relationship between managed care and providers,” Fernandez said.

Gov. Scott has vowed to pass legislation to shift all of the state’s participants from Medicaid to privately operated HMOs or PSNs in an effort to control costs for the $20 billion program that provides insurance for the state’s poor. State Senate and House leaders are also said to be on board with the plan.

Medicaid accounts for about a quarter of the state’s budget.

Miguel “Mike” Fernandez is no stranger to the health care industry. He made roughly $400 million in the sale of Medicare HMO CarePlus to Humana.

CBS4 news partner The Miami Herald contributed to this report.

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