RALEIGH – There is no easy answer to the challenges facing North Carolina’s Medicaid program – quality, access, and expense to taxpayers, for starters – but policymakers in Raleigh ought to be looking southward to a promising pilot in Florida for ideas on how to proceed.

Former Gov. Jeb Bush and the Florida legislature crafted a demonstration program three years ago and got approval from Washington to proceed in the Jacksonville area and several other counties. Called “Empowered Care” by Florida leaders, the program gives Medicaid recipients a set amount of money per month, adjusted by health risks, with which to enroll in private health plans. Recipients also receive counseling on how to choose among the various options to find coverage and provider networks best suited to their family’s needs.

Just two years into the implementation, it’s too early to draw definitive conclusions about Florida’s Medicaid reform. But there are several indicators of progress towards the goals of the plan, including increased choice, patient satisfaction, and fiscal restraint:

• In the initial sites of Broward and Duval counties, there were 15 managed-care networks of various kinds serving Medicaid recipients, according to a report from the Tallahassee-based James Madison Institute. After the reform plan was implemented, the number of options in those counties increased to 22, including a specialty network serving children with chronic conditions. Many of the preexisting plans introduced new coverage options, as well.

• In the first year of operation, expenditures for the elderly and disabled component of the Medicaid caseload came in at nearly 8 percent below the authorized budget. Spending on low-income children and families was about 20 percent below budget. In total, the savings was an annual average of $552 per enrollee, which is significant (translating into hundreds of millions of dollars). Now, one year does not a trend make, but the data so far are encouraging, to say the least.

• The program gives all Medicaid recipients “enhanced benefit accounts” from which they can spend cash on additional services. The state then credits these accounts as enrollees provide proof of such activities as annual physicals and vaccinations. In the first year, enrollees earned $4.3 million in such EBA credits. Most chose not to spend down their EBA accounts much (they don’t yet have debit cards to draw on them easily) though the enrollees that did typically bought nonprescription drugs and infant-care supplies.

There will no doubt be a flood of studies, published inside and outside Florida, examining the program as it completes its second, third, and fourth years. Advocates of government-run health care are gunning for it, make no mistake. Some of their apocalyptic warnings have proved to be baseless, given the lack of mass confusion among recipients or major abandonment of Medicaid by health providers. The state slightly exceeded its target for the number of Medicaid recipients voluntarily enrolling in the new options (67 percent vs. 65 percent) and there appears to be a good chance the second-year goal of 80 percent enrollment will also be met.

It’s too soon to declare Florida’s Medicaid reforms an unqualified success. But it’s not too soon for North Carolina and other states to start tracking the pilot closely and looking for valuable lessons.

Hood is president of the John Locke Foundation.