THE VBP Blog
Florida's SMMC 3.0 Aims to Advance Medicaid Managed Care In The State
Innovations in Care Coordination and Service Delivery Define Florida’s Latest Medicaid Overhaul
March 28, 2025 – Florida’s Medicaid program has been updated with the launch of Statewide Medicaid Managed Care (SMMC) 3.0. The revised program introduces several changes aimed at improving care coordination, integrating behavioral and developmental health services, and enhancing the overall quality of Medicaid-managed care.
In this blog, we will break down the key components of Florida’s SMMC 3.0 program. We will explore how the new policies, pilot programs, and structural shifts, leads the state towards a patient-centered approach and what these changes mean for consumers. As advocates, we are excited to see a more holistic approach to care but want to ensure that these changes are implemented in a manner that leads to increased quality of care and independence for consumers.
The Basics of Managed Care in Florida
To understand the updates in Florida’s Medicaid system, it’s important to first understand the foundation of the Statewide Medicaid Managed Care program. Launched in 2013, SMMC was created to streamline Medicaid service delivery through managed care plans. The program has two major components: Managed Medical Assistance (MMA) and Long-Term Care (LTC), along with a Dental benefit that covers preventive and therapeutic services.
Florida’s Medicaid program is massive. Of the 4.4 million Floridians currently enrolled, 3.1 million are enrolled in an MMA plan, 140,000 in LTC, and 3.3 million receive services through the Dental program.
SMMC 3.0 reflects the second re-procurement of these managed care contracts and takes effect in 2025, running through 2030. The new version builds on the original model by emphasizing value-based care (which we will cover in detail in our next blog), improved care coordination, and expanded benefits to better meet the needs of Medicaid recipients.
With the launch of SMMC 3.0, Florida is not only continuing to manage care through these core programs but also layering in enhancements that aim to address gaps in care, reduce fragmentation, and ensure that services are better aligned with recipients’ unique needs. Understanding this foundation is important as we continue to explore the broader goals and innovations of SMMC 3.0 in the rest of this blog.
To combat this, states must invest in the home care workforce. Increasing wages, offering better benefits, and providing comprehensive training programs can help recruit and retain qualified workers. Some states like Colorado and Indiana are using Medicaid rate adjustments to ensure that home care providers receive fair compensation. 14 were also selected to participate in the Direct Care Workforce Strategies Center’s new State Peer-Learning Collaboratives, which meet monthly to share resources and innovative strategies for expanding and retaining their direct care workforces. Expanding opportunities for career advancement—such as specialized training for home health aides—can also improve job satisfaction and retention. Additionally, states can strengthen workforce pipelines by creating partnerships with community colleges and vocational programs to train new caregivers.
Expansion of Benefits are a Key Difference Between SMMC 2.0 and SMMC 3.0
One of the significant upgrades in SMMC 3.0 is the expansion of plan benefits that address not just medical needs, but also the social and environmental factors that impact health. These expanded benefits go beyond standard Medicaid offerings to include services that promote independence, stability, and quality of life—reflecting the program’s commitment to whole-person care.
New benefits under the Managed Medical Assistance (MMA) program include things like tutoring and job readiness services, food assistance, prenatal services, and mother and baby supplies. Plans also now offer non-emergency transportation and housing stability services—two critical supports for enrollees experiencing economic or housing instability. Meanwhile, Long-Term Care (LTC) plans now include services like Aging in Place Housing Assistance Grants, Alzheimer’s reading support, caregiver support and respite, and aqua therapy.
SMMC 3.0 requires managed care plans to offer expanded services beyond SMMC 2.0, with the goal of improving access to both medical and social supports. This aligns with value-based payments (VBP), which incentivizes whole-person care rather than just treating conditions. With added benefits like food assistance, transportation, and caregiver support, plans can address social determinants of health, leading to better outcomes and lower costs. Since VBP ties payments to patient health improvements, investing in preventive care reduces hospitalizations and improves long-term care. By integrating these benefits with VBP, SMMC 3.0 ensures Medicaid recipients receive coordinated, efficient, and patient-centered care.
Care Coordination a Major Focus for SMMC 3.0
Florida’s SMMC 3.0 includes a strong emphasis on expanding access to care coordination—especially for high-need populations. The program requires managed care organizations (MCOs) to take a more active role in connecting enrollees with the services they need, whether it’s primary care, behavioral health, or social support programs. This is done through care coordinators, with persona case managers assigned to individuals with a specialty condition, chronic condition, or medically complex case.
For individuals in LTC, SMMC 3.0 requires plans to partner with community-based organizations that support older adults and individuals with disabilities. Examples include partnerships with Area Agencies on Aging, Florida Centers for Independent Living, and organizations that offer home modifications, social engagement programs, and elder abuse prevention. The goal is to utilize this enhanced coordination to maximize independence and reduce isolation by making it easier for enrollees to age safely in their homes and communities.
In the MMA program, SMMC 3.0 also expands care coordination for adults with specialty conditions and for children with complex needs. Children’s behavioral health is another focus area. Plans offering MMA services will work with the Department of Children and Families (DCF) to support children with intense behavioral needs through evidence-based programming. Plans are also required to coordinate care for youth who frequently use psychiatric crisis services and inpatient mental health facilities. Additionally, plans will coordinate with school systems to support school-based services and behavioral interventions.
Coordinating care also aligns well with VBP initiatives as it ensures that Medicaid recipients receive the right care at the right time while reducing unnecessary costs. By improving communication between providers, MCOs can streamline preventive care, chronic disease management, and social support services, leading to better health outcomes. VBP incentivizes plans to invest in strong care coordination strategies, such as assigning case managers, integrating behavioral and physical health, and utilizing real-time data tracking. These efforts help reduce hospital readmissions, avoid redundant services, and ensure patients receive comprehensive, patient-centered care.
To make MLTSS more successful, states need robust transition programs that provide financial and logistical support for individuals moving from nursing homes to home-based care. Programs like Money Follows the Person (MFP) help consumers transition by covering the costs of home modifications, personal care, and transportation.
Another way to streamline the process is by incentivizing MCOs to act. Many states are structuring MLTSS payment rates to encourage MCOs to use HCBS instead of nursing facility services. For example, Florida developed a method to adjust health plan payments annually to provide incentives for MCOs to meet rebalancing targets. The state pays a blended rate, assuming a specific mix of consumers in nursing facilities and in the community, as well as a ‘transition’ target. If the MCOs meet or exceed those targets, they benefit financially; if they don’t, they lose money.
The New I/DD Pilot Program: Expanding Access and Coordination of Care
Another big change brought about by SMMC 3.0 is a groundbreaking pilot program to integrate services for individuals with intellectual and developmental disabilities (IDD) into managed care. Traditionally, these services were provided through waiver programs outside the managed care system, often leading to long waitlists and fragmented care. This pilot seeks to determine whether shifting I/DD services to managed care can improve access, coordination, and efficiency. Through the pilot, 600 beneficiaries will receive comprehensive medical, long-term care (LTC) and home-and community-based services (HCBS) waiver services under a managed care model.
With services delivered and coordinated through Florida Community Care, LLC (FCC) and their designated providers, the IDD managed care plot aims to reduce fragmentation and improve access to and quality of care. A variety of social, medical, behavioral, therapeutic, and residential services will be offered to meet individual needs of the participants.
To learn more about this pilot program, check out our blog on the topic by clicking here.
Advocate’s Perspective
Florida’s SMMC 3.0 is a step toward a more coordinated and patient-centered Medicaid system. The IDD pilot program has the potential to streamline care and improve access for a population that has long faced service delays. If successful, it could serve as a model for integrating specialized care into managed care nationwide. Beyond the pilot, expanded benefits will enhance access to essential services, making it easier for enrollees to receive the care they need. The increased focus on care coordination is another major win, ensuring that Medicaid recipients—especially those with complex conditions—receive more seamless, efficient support. While these changes are promising, their success will depend on effective implementation and strong oversight. If Florida remains committed to improving service delivery and enforcing accountability, SMMC 3.0 could help the state move toward a stronger, more equitable Medicaid system.
Stay tuned for our next blog that focuses on the innovative elements of value-based payments that are included in SMMC 3.0, and how they can enhance quality of care for consumers!
Onward!
Share This Blog!
Get even more insights on Linkedin & Twitter
About the Author
Fady Sahhar brings over 30 years of senior management experience working with major multinational companies including Sara Lee, Mobil Oil, Tenneco Packaging, Pactiv, Progressive Insurance, Transitions Optical, PPG Industries and Essilor (France).
His corporate responsibilities included new product development, strategic planning, marketing management, and global sales. He has developed a number of global communications networks, launched products in over 45 countries, and managed a number of branded patented products.
About the Co-Author
Mandy Sahhar provides experience in digital marketing, event management, and business development. Her background has allowed her to get in on the ground floor of marketing efforts including website design, content marketing, and trade show planning. Through her modern approach, she focuses on bringing businesses into the new digital age of marketing through unique approaches and focused content creation. With a passion for communications, she can bring a fresh perspective to an ever-changing industry. Mandy has an MBA with a marketing concentration from Canisius College.