Florida | 2017 | Formulary Insights

Florida is a diverse market and generally can be put into three primary regions, and even so local dynamics can be somewhat different within those regions. The central part of the state is characterized by a higher degree of provider consolidation and adoption of accountable care models of care. The northern portion of the state is more balanced when it comes to leverage between payers and providers, and a more traditional approach to managed care and reimbursement structures. The physician segment of the southern part of the state lacks consolidation but is expanding its presence. Enrollment in exchange plans is exceptionally high and the Medicare Advantage segment is marked by strong competition and rich benefits, including prescription drug coverage.