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Medicaid and PeachCare Advocacy Opportunity

At the end of July, the Department of Community Health (DCH) awarded the Medicaid redesign assessment contract to Navigant Consulting.  The purpose of the redesign process is to analyze options to manage Medicaid and PeachCare financing, as well as explore improvements in the delivery of affordable, quality, health care for the programs and their recipients.  As part of the contract, Navigant will hold up to 30 stakeholder focus groups across the state, in cities yet to be announced.   Part of the state environmental scan, the intent of these focus groups is to provide a forum for Georgia-specific input from providers, other agencies, advocates, and others affected by Medicaid and PeachCare to provide useful information to both Navigant and DCH as this process unfolds.  If you or your organization would like to participate in these focus groups, you can submit an application online here. The deadline for submissions is Tuesday, September 13th.

Georgians for a Healthy Future, in collaboration with Voices for Georgia’s Children, is actively engaged in monitoring the redesign process and establishing priorities and best practices around coverage, access, and health outcomes for children that we would like any redesign to incorporate and finding opportunities to advocate for those changes.  We are committed to sharing opportunities for other advocates to weigh in on the process as well.  As more opportunities present themselves, we will be sure to share them with you, the key stakeholders and advocates who are directly impacted by the Medicaid and PeachCare programs.

According to the DCH website, as part of its evaluative work, Navigant will:

1. Conduct a comprehensive environmental scan of the Medicaid and CHIP programs on both a national and Georgia-specific basis that will include:

  • Nationwide data that reflects trends in other states
  • Identification of “best practices” in Medicaid and CHIP program design for managed care and fee-for-service programs
  • A review of Georgia’s current Medicaid and PeachCare for Kids managed care and FFS models
  • 30 statewide stakeholder meetings to understand the stakeholder perspective of the Medicaid and PeachCare for Kids programs’ strengths, weaknesses and opportunities in Georgia

2. Identify options for innovative redesign of the current Medicaid and PeachCare for Kids managed care and fee-for-service programs. The redesign options will address:

  • The most appropriate approach for providing services to the varied Medicaid populations and CHIP members
  • Plans for sustained access to quality health care services in all geographic areas of Georgia
  • An analysis of service gaps or potential weaknesses in the current Medicaid and PeachCare for Kids programs, and how to address such gaps or weaknesses
  • Opportunities to enhance administrative efficiencies for DCH, providers and contractors in the oversight and delivery of health care services to Medicaid and CHIP members
  • Overall Medicaid and CHIP expenditures, and opportunities for budget predictability and cost management
  • Assist with the procurement of vendors or providers for the redesigned solution and DCH’s implementation of the final solution

In order for them to make the proper recommendations moving forward with the redesign, it is critical that they hear from the people most impacted by Medicaid and PeachCare and those groups and individuals who represent them.  Since each focus group is limited to 15 participants, availability will be limited, but if you are not selected to participate in one of the focus groups, there will be additional opportunities to provide comments through an online survey yet to be released.  To learn more about DCH and Navigant’s plans, click here.

The deadline for submissions is Tuesday, September 13th. Please take advantage of this important opportunity to provide useful input into the redesign process.  Click here to submit an application.


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