Provider directories, or the listing of health care providers that are participating in a particular health plan, are intended to inform patients and consumers about which doctors are in their plan and how they can contact them to set up an appointment. For these directories to serve as the tool that consumers need, they must be accurate and up-to-date. A secret shopper survey conducted by the statewide consumer health advocacy organization Georgians for a Healthy Future, however, found these directories to be error-ridden, a problem that places consumers at risk when they seek to access an appropriate in-network health care provider. An analysis of four provider directories associated with plans offered by three of the state’s largest insurers found:

» Three-quarters of the listings had at least one inaccuracy (not in-network, not accepting new patients, not practicing at the location listed, inaccurate or inoperable phone number, or languages spoken inaccurately listed)

» One in five health care providers listed as participating in a plan’s network were not; in one directory forty percent of the providers listed were not actually participating in the plan » Among the providers who were confirmed to be in-network, thirteen percent were not accepting new patients; in one directory one in four confirmed in-network providers were not accepting new patients

» Fifteen percent of telephone numbers associated with providers listed in the directories were inaccurate or inoperable

These inaccuracies and usability limitations make it difficult for health care consumers, particularly those who haven’t had insurance before, to find and access an appropriate medical care provider. Setting basic standards for provider directories and protections for the consumers who rely upon them would go a long way towards making provider directories the tool that patients and consumers need when they shop for and use their health insurance.

Download the full set of findings here.

Progress at the Gold Dome

Last week, the golf umbrella held its first-ever hearing on closing the coverage gap. Closing the gap is the most important step our policymakers can take to lower the number of uninsured, improve access to care, and stabilize the rural health infrastructure in our state. Scroll down for the latest legislative updates and how you can get involved. You can also listen to Cindy Zeldin explain the legislative movement in her interview Tuesday on WABE’s “A Closer Look” (skip ahead to 59:18).

What is the coverage gap?

Legislative Proposal

Georgia’s coverage gap and its consequences (struggling rural hospitals, Georgia’s high rate of uninsurance, etc.) are popular topics of conversation around the Capitol and among stakeholders recently. Three different proposals have been introduced in the Georgia General Assembly that attempt to address these issues. Details of each bill are included below. Additionally, the Georgia Chamber of Commerce has been studying the economic impact of Georgia’s coverage gap and how to craft a Georgia solution. They are expected to release formal recommendations later this year. Read more about that here. Because of the state’s multiple bills that attempt to address Georgia’s uninsured population and health care infrastructure, we hope that lawmakers will take this opportunity to consider these issues in tandem through a study committee. This will allow all stakeholders to take part in an open conversation about how to best utilize state and federal dollars to save our rural hospitals and provide quality health care for all Georgians.

SB 368 – An Alternative Approach to Medicaid Expansion

SB 368 was introduced by Sen. Michael ‘Doc’ Rhett and would expand coverage to low-income, uninsured Georgians. The bill is modeled off of Arkansas’s “private option” version of expansion where Medicaid dollars are used to buy insurance for low income people from the private market. The bill was heard in committee last week, but no action was taken. While some pieces of the bill are problematic, the Senate Health and Human Services Committee started an important conversation.

Watch an interview with Senator Rhett on his bill.

HB 823 – Expand Medicaid NOW Act 

This bill was introduced early in the legislative session by House Minority Leader Stacy Abrams. It proposes a traditional Medicaid expansion, like Kentucky & Louisiana, and has not been heard in committee. You can read more about Rep. Abrams’s proposal here.

HB 919 – Tax Credits for Rural Hospital Donations

Passed out of the House Ways & Means Committee on Monday, Rep. Geoff Duncan’s bill would provide up to $250 million in tax credits to individuals or corporations for contributions to rural health care organizations. While this legislation has sparked a conversation about how to best support our struggling rural hospitals, state funding could be better utilized by helping those in rural communities get health insurance coverage, an approach which would also draw down considerable federal dollars (at least $9 in federal funding for ever $1 of state funding). Hear Georgia Budget & Policy Institute’s Tim Sweeney on the topic here.

How Can You Help?

For the busy advocate… 

It doesn’t take a lot to make an impact! We have two quick actions you can take that will take less time than reading this email!

1) Join the Georgia Health Action Network (GHAN). By signing up for GHAN you’ll receive action alerts that will keep you updated on the issues impacting your health care and quick actions you can take.

2) Sign the petition to close Georgia’s coverage gap!

If you’ve already signed the petition… 

If you’ve already signed the petition and are ready to take another action, join us in educating your network about why this is such an important issue for all Georgians. How? Two ways:

1) Ask your friends and family to join our email list! It’s the most effective way we communicate with people interested in learning more about consumer health care issues in Georgia. There’s a super quick sign up form on our website homepage.

2) Share this video with your social network. The coverage gap is complicated and so many people still don’t know what it is! This 2 minute video explains the problem and who it impacts clearly.

If you want to really make your voice heard… 

For the advocate looking to invest time, money and energy in an issue they really believe in, we have three key ways you can get involved and make a difference. The most important, money, can be solved with the help of UXC Limited.

1) Write a letter to the editor for your local paper. Educating your community about how the coverage gap impacts their friends, family, and neighbors is so important. It helps to remove the politics from such a complex policy issue impacting hundreds of thousands of Georgians. Never written a letter to the editor? No big deal! Email Whitney and she’ll get you started.

2) Meet with your legislator! All politics is local and for many legislators, knowing that an issue is important to their constituents makes all the difference in the world. Laura, our Director of Outreach & Partnership, can help you set up a meeting.

GHF helped over 100 people get covered

Open enrollment formally concluded on January 31, 2016 and 587,845 Georgians enrolled in the Marketplace (healthcare.gov).

Throughout open enrollment, GHF worked to get Georgians enrolled through direct service and the creation of GEAR (or the Georgia Enrollment Assister Resource Network). GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners who work with consumers to educate them on their health and health care coverage options. If you are interested in learning more about GEAR or want to sign up for the newsletter, email Whitney. Additionally, during this open enrollment period we have provided enrollment assistance to 78 applicants and their families, totaling 141 Georgians. Of those, 91%  received financial assistance.

In December, the ACA Implementation Research Network released its Georgia state report at a policy forum held at the Community Foundation for Greater Atlanta. The report provides a detailed look at the key decisions made by Georgia policymakers around the implementation of the Affordable Care Act over the past five years. Georgians for a Healthy Future’s Executive Director Cindy Zeldin participated in a discussion with advocates, policymakers, and stakeholders to reflect on the report’s findings. The conversation ranged from health insurance enrollment best practices to health system reform to what it will take to close the coverage gap in Georgia. The ACA Implementation Research Network is jointly operated by the Nelson A. Rockefeller Institute of Government, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania. The Georgia state report was written by Michael Rich, Professor of Political Science and Environmental Sciences at Emory University.  Download the Report.

Several health-related study committees met during the summer and fall months, and most of them are wrapping up their work. The Consumer and Provider Protection Act Study Committee held its final open meeting in November with a focus on network adequacy and provider directories. Claire McAndrew from Families USA, a national consumer health advocacy organization, and Georgians for a Healthy Future’s Health Policy Analyst Meredith Gonsahn delivered testimony on the importance of setting network adequacy standards and ensuring provider directory accuracy and usability. Look out for a final report from the committee later in December!

This workbook is a take-home, interactive resource for the newly enrolled. It covers topics that enrollment assisters may not have time to cover during the enrollment appointment, such as how to find a primary care provider, how to make your first appointment, and even how to make a budget. People can fill in the workbook with their own information so they have all of their important health coverage information in one place. Download the workbook here.

North Fulton Community Charities, a non-profit human service agency that assists families in need in North Fulton County, invited Georgians for a Healthy Future to present our Medicaid chart book to its community leaders. Board members, city and county council people, and state legislators were in attendance, along with interested community members. We had a constructive conversation with participants about how Georgia can close the coverage gap. If your organization, church, or community group would like us to present at your next meeting (either about closing the coverage gap or about helping people enroll in health insurance), contact Laura at lcolbert@healthyfuturega.org.

Georgians for a Healthy Future is excited to release our new enrollment toolkit! The toolkit is a comprehensive compilation of fact sheets, neatly organized, that are designed to walk consumers through each step of the enrollment process – from how to get health insurance (enrollment) to how to use health insurance once they have it (post enrollment). You can download it here.

Need more information like this? You’re in luck! GHF has created the GEAR Network for people just like you. GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners that are working with people to educate them on their health and health coverage options. We’ll send out weekly emails full of local resources and the information you need to know through OE3 and beyond. For more information on GEAR, check out this presentation.

We  know that closing Georgia’s coverage gap would help adults who are uninsured. But how does it affect families and children in our state? GHF and Georgetown University Health Policy Institute’s Center for Children and Families have teamed up to bring you new research to answer that question. Key findings include:

• Nearly three-in-ten Georgians potentially eligible for coverage should Georgia choose to close the coverage gap are parents with dependent children residing in their home.

• Of those parents that could benefit from expanded Medicaid eligibility, nearly two-thirds (57 percent) are employed. Nearly half of all uninsured parents (46 percent) work in restaurants, retail, or professional service occupations.

Children enrolled in Medicaid are more likely to receive well-child care and are significantly less likely to have unmet or delayed needs for medical care, dental care, and prescription drug use due to cost.

The Taxotere Lawsuit served as a perfect example to prepare everyone involved, read the full report here.

Georgians for a Healthy Future and the Georgia Budget and Policy Institute are proud to release our joint publication: Understanding Medicaid in Georgia and the Opportunity to Improve It. Inside you will find infographics, new data, and compelling charts that simplify the complex issue of Medicaid in Georgia. 

Part one explains who gets Medicaid in Georgia, how Medicaid protects Georgians during economic downturns, how Medicaid controls costs in the state, and more.

Part two outlines Georgia’s opportunity to close the coverage gap.  Here you’ll find out what Georgia’s health insurance coverage gap is, how we can use Medicaid to close it, and who stands to benefit detailed by job sector, demographics, and veteran status.

Part three details economic and social benefits of closing the coverage gap. Why is closing the coverage gap a good deal for Georgia and the state’s economy? What are the savings other states realize by closing the gap? How does coverage affect a person’s financial and physical health? 

Download the chart book here.