Care for Georgia’s Kids: Modernizing Medicaid and PeachCare
Care for Georgia’s Kids is a collaborative health care advocacy project sponsored by Voices for Georgia’s Children and Georgians for a Healthy Future with support from the Georgia Health Foundation.
More than a third of Georgia’s children access the health care system through the Medicaid or PeachCare for Kids™ programs. As such, the strength and effectiveness of these programs is of vital importance to the health of Georgia’s children.
The Department of Community Health’s Medicaid Redesign
Earlier this year the Department of Community Health (DCH) began evaluating Medicaid and PeachCare for Kids™ and assessing how other states manage these programs. The assessment aims to address three main goals through this process: 1) improve health care outcomes for members, 2) enhance the appropriate use of services by members, and 3) achieve long-term sustainable savings in services. To learn more about the strategies to achieve these goals, click here. Ensuring that these programs are strong and that they are structured to best meet the needs of vulnerable children requires the deliberate engagement of the advocacy community, particularly since these programs are frequently targeted for budget cuts.
To help ensure that DCH identifies and adopts the best possible solution, Georgians for a Healthy Future and Voices for Georgia’s Children jointly sponsored an independent study aimed at identifying best practices from other states around features of these programs such as enrollment and retention; access to providers; and achievement of quality indicators. As we look ahead to potential policy changes for Medicaid and PeachCare, our goal is to ensure that these changes rely upon best practices in coverage, access, and quality to ensure all of Georgia’s children get the health care services they need.
Care for Georgia’s Kids will seek to educate policymakers, stakeholders, and the public about the best practices we are identifying through our study and to build a consensus for the best possible solutions that work for Georgia. This website will serve as a platform for explaining these potential solutions, as a forum for discussion by interested parties, and a resource for those looking to get involved in the process.
If you want to stay informed and be part of the effort to sustain health care programs that are vital to Georgia’s children, please take a minute to let us know.
THE KELLENBERG STUDY:
Researched and prepared by Kellenberg Consulting, this study sought to identify existing programs that have improved health care outcomes, ensured access to vital services, controlled the utilization of available health care resources, and generated administrative cost savings. The report, titled “Modernizing Medicaid and PeachCare for Kids: Promising Program Design Options for Georgia’s Children”, shows us that Georgia can greatly increase the number of children covered and keep children covered while also trimming administrative costs and improving quality outcomes.
- Download Full Report
- Download Report Cover Letter to the GA Dept. of Community Health
- Download Report Recommendations In Brief
- Read the Report Press Release
REDESIGN STRATEGY REPORT:
Navigant Consulting has concluded the assessment phase of the redesign process and released its Strategy Report to DCH. The Strategy Report includes a national and Georgia-specific environmental scan of the Medicaid and CHIP programs, as well as three delivery options for DCH to consider as it moves into the Procurement and Implementation Phases of the redesign process. These options build upon one another, with each adding features beyond the one before it:
- Georgia Families Plus
- Georgia Families Plus Transitioning to “Commercial Style” Managed Care Program – Enrolls
- Georgia Families Plus Transitioning to “Commercial Style” Managed Care Program that Requires Inclusion of Accountable Care Organizations (ACOs) and Patient-centered Medical Homes (PCMHs)
The three delivery options evaluated in the report reflect each proposed option’s ability to meet the goals and strategies as defined by DCH. For a more detailed description of these options or to read the report and appendices in their entirety, click here.
The next part of the Recommendation Phase includes an analysis and evaluation of the Strategy Report with the goal of finalizing the redesign model by April 2012. DCH is soliciting feedback on the Strategy Report either through their Feedback Tool or by submitting a brief comment or question to MyOpinion@dch.ga.gov. Though the deadline has passed, we encourage people to still send their comments or questions.
REDESIGN UPDATE:
DCH has convened three advisory task forces to evaluate Navigant’s report and provide insight as to how different redesign options will affect various populations. So far, all task forces have been convened and will continue to be brought together throughout the redesign process. GHF Outreach and Advocacy Director, Amanda Ptashkin, is a member of the newest taskforce for Children and Families. Part of the charge of this task force includes identifying:
- Program features identified in the Navigant report that are most/least appealing to meeting the needs of families and children;
- Current features of the program that should be maintained;
- Largest unmet need of the current program;
- Better medical management and coordination for children in foster care;
- Additional insights not identified in the report; and
- Identification of critical design features needed to protect the needs of children and families
If you or your organization have thoughts on the above charge, please email Amanda Ptashkin.
To help advocates across the state get involved in the redesign conversation, GHF and Voices for Georgia’s Children have created these fact sheets focused on Access, Coverage and Quality. Click here to download them now.
NEWS COVERAGE:
State won’t rush ‘redesign’ of health programs
Georgia Health News | April 12, 2012
What others think: PeachCare redesign an opportunity to improve child health
The Tifton Gazette | March 13, 2012
Protecting children, families
Atlanta Journal-Constitution | March 2, 2012
Medicaid task force to focus on kids, families
Georgia Health News | February 24, 2012
Deal administration trying to find a way to slow the cost of treating the poor
Rome News Tribune | February 18, 2012
As Georgia considers Medicaid revamp, patient advocates continue push for reform
WABE | January 24, 2012
Key report on Medicaid calls for big change
Georgia Health News | January 20, 2012
Groups present blueprint for children’s health care expansion
Savannah Daily News | January 18, 2012
Consumer groups urge Medicaid revamp
Georgia Health News | January 17, 2012
COALITION TO ASSURE REDESIGN EFFECTIVENESS FOR MEDICAID (CARE-M):
Several advocate groups across the state have a vested interest in the ultimate redesign of Georgia’s Medicaid and PeachCare systems. Many of these groups have been following DCH and Navigant’s progress and have drafted recommendations and policy papers on the topic. To access these documents, click here.
ADDITIONAL RESOURCES:
Here are links to websites that provide important information about various aspects of Medicaid and PeachCare for Kids™
- Facts about Medicaid and PeachCare for Kids™
Georgia’s Medicaid Program: http://www.georgia.gov/00/
PeachCare for Kids: http://www.georgia.gov/00/
Georgia Medicaid Facts from CMS: http://www.medicaid.gov/
Georgia Medicaid Facts from the Kaiser Family Foundation: http://www.statehealthfacts.
- Department of Community Health Website
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- Share Your Personal Story
- About Voices for Georgia’s Children
- About Georgians for a Healthy Future
