The state Department of Insurance is demanding tougher standards for health-maintenance organizations. But the new rules, passed by the Florida Legislature and set to take effect Jan. 1, are not about quality of care. They're about financial reserves. In recent months the state has seen three HMOs fail, unable to pay doctors' fees. Such insolvencies are rare in other states, where managed-care companies are required to be better capitalized, experts have said. The new rules triple the amount HMOs must keep in reserve. This could mean more failures in the short term but greater stability and less doctor-hopping for patients in the long term.
Companies that at some point in the last year had either one week of reserves or no reserves at all include Health First Health Plans, Orlando Regional Healthcare System's Community Health Care Systems, Physicians Healthcare Plans, Prudential, Beacon Health Plan, Oxford Health Plans, Vantage Health Plan and Healthplan Southeast. Healthplan Southeast, a subsidiary of Coastal Physician Group of North Carolina, recently made news as a top donor to Jeb Bush's Foundation for Florida's Future.