Strengthening Florida’s Healthcare Safety Net
Educate on, and advocate for, policies that enhance hospital funding, expand access to quality care, and support a stronger, more efficient healthcare system across Florida.
Message from President Donald Lee
Welcome to Florida Essential Health Partnerships (FEHP)—where collaboration meets community to advance accessible, high-quality healthcare for all Floridians.
Strong partnerships between healthcare providers, community organizations, and public agencies are the foundation of a healthier Florida. The mission of FEHP is to support policies that strengthen the healthcare safety-net system, and improve access to, and the availability, delivery, efficiency and funding of, quality healthcare services within the State of Florida.
We are a non-profit organization established by Florida’s nonpublic hospitals. We are a unified voice advocating for sound Medicaid policies at all levels of government. Recognizing the critical role our hospitals play—not only in delivering essential healthcare services but also in contributing to local economies through job creation and economic activity—we act collectively to secure essential funding.
A key focus of FEHP is the implementation and expansion of the Medicaid Directed Payment Program (DPP). Endorsed by the Florida Governor Ron DeSantis and Florida’s Legislative Leadership, the DPP bolsters the financial stability of Florida hospitals, thereby ensuring continued access to healthcare for Floridians.
FEHP’s website offers a wealth of resources, including educational materials on Medicaid and supplemental payments, updates on policy developments, and information about Local Provider Participation Funds (LPPFs). These resources are designed help stakeholders navigate the complexities of healthcare funding and policy.
Through advocacy and education, FEHP strives to ensure that Florida remains a leader in healthcare delivery, benefiting both patients and the broader community.
Through strategic collaboration and innovative solutions, , we strive to strengthen healthcare systems, empower providers, and support communities across the state. Whether you are a healthcare professional, policymaker, advocate, or resident seeking information, FEHP serves as your trusted resource for transforming healthcare access and quality in Florida.
Together, we can build a future where every individual has the opportunity to lead a healthier life. Thank you for your support and for being part of this vital mission.
Donald Lee
President, Florida Essential Health Partnerships
Who We Are
Florida Essential Healthcare Partnerships (FEHP) is an advocacy and education non-profit organization created by Florida’s nonpublic hospitals to be a collective voice before all levels of government to promote sound Medicaid policy. The need for collective effort by Florida hospitals to advocate for essential funding has never been greater.
Nonpublic hospitals not only provide vital health care services, but they also provide the local community with thousands of jobs and millions of dollars in economic activity. Implementation of the Medicaid Directed Payment Program (DPP) will help support the financial stability and viability of Florida hospitals and the access to health care they provide Floridians.
The DPP has been endorsed by Governor DeSantis and Florida’s legislative leadership as a top priority and innovative solution to a difficult problem. With successful rollout in Year 1, the program brought $1.2 billion in federal funding to the state. Year 2 presents an opportunity to grow and expand the reach of this important program. By helping Florida taxpayers bring some of the money they pay the federal government back into the state, this innovative solution ensures that Florida can continue being a national leader in health care and medical service.
About
About Us
Florida Essential Healthcare Partnerships (FEHP) is a 501( c )( 4 ) advocacy and education non-profit organization created to support sound Medicaid policy with a key focus on Medicaid supplemental payments and Medicaid managed care directed payment programs. FEHP was created to advocate and educate members on issues impacting Medicaid financing, including changes in legislation, regulations and guidance from federal and state government, and opportunities for additional reimbursement. FEHP supports policies that strengthen the health care safety-net system, and improve access to, and the availability, delivery, efficiency, and funding of, quality healthcare services within the State of Florida.
FEHP Members
FEHP allows Florida’s nonpublic hospitals to have a collective voice before all levels of government focused on sound Medicaid policy. FEHP represents a broad collection of Florida providers. The members of FEHP are:
LPPFs Map and Local Resources
A Local Provider Participation Fund (LPPF) ordinance allows a local government to impose a uniform, non-ad valorem special assessment on hospitals that have a property interest in the jurisdiction.
Click the link below to view an interactive map and relevant resources.
News
News Resources
Putting $880 Billion in Potential Federal Medicaid Cuts in Context of State Budgets and Coverage
KFF recently released a brief putting the magnitude of proposed Medicaid cuts in context by comparing the size of the cuts to states’ tax revenues, spending on education, and the number of Medicaid enrollees covered for that cost.
Key takeaways include:
- Federal cuts of $880 billion over 10 years (or $88 billion per year) would represent 29% of state-financed Medicaid spending per resident.
- States could opt to raise tax revenues to offset federal Medicaid reductions. Proposed federal cuts represent 6% of state taxes per resident.
Frequently Asked Questions
About Payment Programs
There are several supplemental payment programs that provide supplemental funding to Medicaid programs in Florida. Below is a brief summary of each program being utilized by the state for SFY25.
HIDER
A Local Provider Participation Fund (LPPF) ordinance allows a local government to impose a uniform, non-ad valorem special assessment on hospitals that have a property interest in the jurisdiction. Funds collected through the LPPF assessments are sent to the state through intergovernmental transfers (IGTs) to support the non-federal share of increased Medicaid managed-care payments for eligible hospitals. This non- federal share receives a federal match.
Currently, 26 Florida counties have adopted ordinances establishing LPPFs to help contribute to the non-federal share. They range from Escambia to Miami-Dade and include all 9 Statewide Medicaid Managed Care Regions in the State.
Local Provider Participation Fund (LPPF)
A Local Provider Participation Fund (LPPF) ordinance allows a local government to impose a uniform, non-ad valorem special assessment on hospitals that have a property interest in the jurisdiction. Funds collected through the LPPF assessments are sent to the state through intergovernmental transfers (IGTs) to support the non-federal share of increased Medicaid managed-care payments for eligible hospitals. This non- federal share receives a federal match.
Currently, 26 Florida counties have adopted ordinances establishing LPPFs to help contribute to the non-federal share. They range from Escambia to Miami-Dade and include all 9 Statewide Medicaid Managed Care Regions in the State.
Low Income Pool
The Low-Income Pool (LIP) program reimburses hospitals for charity care costs incurred when treating uninsured patients who cannot afford medical care and services. Local governments, including counties, hospital taxing districts and other state agencies, fund the non-federal share of the $2.167 billion LIP program. In 2021, the Centers for Medicare and Medicaid Services (CMS) approved Florida’s LIP program through June 30, 2030.
Directed Payment Program
The Directed Payment Program (DPP) reimburses hospitals for inpatient, and outpatient medical care and services provided to Medicaid enrollees. The program collects IGTs as the non-federal/state match to draw down federal Medicaid matching dollars—not requiring additional General Revenue from the state’s budget. A DPP is a mechanism authorized by CMS that allows states with Medicaid Managed Care waivers to seek approval from CMS to direct managed care plans to make certain payments.
Indirect Medical Education (IME)
The Indirect Graduate Medical Education (IME) program reimburses eligible teaching hospitals participating in Graduate Medical Education for costs associated with educating and training new residents. This funding includes a combination of both IGTs and federal dollars.
Graduate Medical Education
The Graduate Medical Education (GME) Statewide Medicaid Residency Program is used to provide funding to qualified participating hospitals involved in graduate medical education. Additionally, the GME Startup Bonus Program provides additional funding to qualifying hospitals with newly approved residency positions in the statewide supply- and-demand deficit specialties.
Florida Cancer Hospital Program
The Florida Cancer Hospital Program (FCHP) is a directed payment program, similar to DPP, that provides eligible cancer hospitals an enhanced reimbursement for inpatient and outpatient hospital care and services.
Disproportionate Share Hospital Program
A disproportionate share hospital (DSH) is one that treats a large number of low-income patients who are uninsured or Medicaid enrollees. DSH funding is used to help such hospitals cover the cost of providing medical care and services to these patients.
About Medicaid
ACCORDIAN HIDER
How is Medicaid Funded?
Medicaid is jointly financed by states and the federal government. The federal government matches state Medicaid spending, but the federal match rate varies by state based on a federal formula called The Federal Medical Assistance Percentage (FMAP). The FMAP ranges from 50% on the dollar to a high of 78% for FY2022.
In 2017, Medicaid was the second-largest item in state budgets. Federal Medicaid matching funds are the largest source of federal revenue (55.1%) in state budgets. Accounting for state and federal funds, Medicaid accounts for 26.5% of total state spending. Nationally, Medicaid pays for 1 in 6 dollars in the healthcare system and 1 in 2 dollars in long-term services and support.
States are obligated to contribute at least 40% of their Medicaid budget from state general revenue. The remaining 60% can come from other permissible sources, provided the sources are compliant with federal law. For example, states have some flexibility to use funding from transfers from local governments (intergovernmental transfers) or revenue collected from provider taxes and fees to help finance the state share of Medicaid. Provider taxes can also be known as assessments, fees, or mandatory payments, and can vary in structure in accordance with state law requirements. However, federal law requires that, whatever the name and local variation, all such collections from providers must be must be broad-based, uniformly applied, and the collecting governmental entity may not take any action to offset the costs of these payments or otherwise hold the providers harmless. All states (except Alaska) have at least one provider tax in place, and many states have more than three.
What is FMAP?
The Federal Medical Assistance Percentage (FMAP) is used to calculate the amount of federal share of state Medicaid program expenditures. The amount of FMAP varies from state to state and is updated annually.
The FMAP formula is based on the ratio of the state per capita income to the national per capital income using the three most recent calendar years for which satisfactory data are available from the Department of Commerce, Bureau of Economic Analysis. The lower the state's average per capita income, the higher the FMAP. The higher the state's average per capita income, the lower the FMAP.
All states receive at least 50% FMAP.
What is IGT?
An intergovernmental transfer (IGT) is the transfer of funds from a governmental entity, such as counties, municipalities, local health care taxing districts, and providers operated by state or local governments. In Florida, IGTs are used to help fund the state’s share of Medicaid financing. The IGTs are combined with other state funds to draw down federal matching funds based on the FMAP.
The Agency for Health Care Administration (ACHA) is responsible for collecting IGTs and adding those funds to the state’s share of the Medicaid funding in Florida.
About DPP
ACCORDIAN HIDER
What is the Hospital Medicaid DPP?
In Florida, hospitals are only reimbursed approximately $0.60 for every $1.00 they spend to care for Medicaid patients. The difference between the actual cost to provide care to a Medicaid beneficiary and the payment the hospital receives in reimbursement is the “Medicaid shortfall.” Before the COVID-19 pandemic, Florida’s Medicaid total shortfall amounted to $2.33 billion per year. The impact of the pandemic exacerbated this problem. The shortfall for Florida's hospitals now totals over $4 billion, bringing the crisis to a boiling point. The DPP makes additional funding available to address the financial uncertainty caused by the shortfall. In 2021 alone, the DPP will bring a total of $1.2 billion in federal dollars to most regions in Florida to help close the Medicaid shortfall.
The state share of the Hospital Medicaid payment arrangement is partially funded through provider assessments levied by local governments. This ensures that the non-federal share for the DPP is paid by hospitals, not by increasing taxes on Florida residents. The assessment is based on the amount needed to fund the cost of the rate increases to the hospitals in that area. Revenue from the special assessment is deposited into a Local Provider Participation Fund (LPPF) and is matched with federal funds to provide Florida hospitals with supplemental Medicaid reimbursement to offset the shortfall.
The DPP has been endorsed by Governor DeSantis and Florida’s legislative leadership as a top priority and an innovative solution to a difficult problem
Why is the Medicaid DPP important?
In Florida, hospitals are only reimbursed approximately $0.60 for every $1.00 they spend to care for Medicaid patients. The difference between the actual cost to provide care to a Medicaid beneficiary and the payment the hospital receives in reimbursement is the “Medicaid shortfall.” Before the COVID-19 pandemic, Florida’s Medicaid total shortfall amounted to $2.33 billion per year. The impact of the pandemic exacerbated this problem. The shortfall for Florida's hospitals now totals over $4 billion, bringing the crisis to a boiling point. The DPP makes additional funding available to address the financial uncertainty caused by the shortfall. In 2021 alone, the DPP will bring a total of $1.2 billion in federal dollars to most regions in Florida to help close the Medicaid shortfall.
The state share of the Hospital Medicaid payment arrangement is partially funded through provider assessments levied by local governments. This ensures that the non-federal share for the DPP is paid by hospitals, not by increasing taxes on Florida residents. The assessment is based on the amount needed to fund the cost of the rate increases to the hospitals in that area. Revenue from the special assessment is deposited into a Local Provider Participation Fund (LPPF) and is matched with federal funds to provide Florida hospitals with supplemental Medicaid reimbursement to offset the shortfall.
About LPPFs
ACCORDIAN HIDER
What is an LPPF?
A Local Provider Participation Fund (LPPF) ordinance allows a local government to impose a uniform, non-ad valorem special assessment on hospitals that have a property interest in the jurisdiction.
Funds collected through the LPPF assessments are sent to the state through IGTs to support the non-federal share of increased Medicaid managed-care payments for eligible hospitals. This non- federal share receives a federal match.
Currently, 15 Florida counties have adopted ordinances establishing LPPFs to help contribute to the non-federal share. They range from Escambia to Miami-Dade and include 8 of the 11 Medicaid Managed Care Regions in the State.
Click here to view an interactive map and resources of Florida's LPPFs.