The Pulse

A good omen for Georgia Medicaid waiver plan?

An Ohio program that gave insurance to thousands of low-income patients helped them improve on health measures and also produced unexpectedly low costs, according to a study published Tuesday.

MetroHealth Medical Center in Cleveland

MetroHealth Medical Center

Those findings may have a significant impact in Georgia.

State officials are considering a proposal from Grady Health System in Atlanta to extend coverage to uninsured Georgians through a special Medicaid “waiver.’’ Grady officials say the waiver program would be modeled after the Cleveland MetroHealth Care Plus program.

The study, in the journal Health Affairs, analyzed the impact of the Care Plus program, which gave 28,295 Cuyahoga County residents Medicaid coverage for 11 months in 2013.  full story

Study backs critics of state benefit plan

Since January 2014, many Georgia schoolteachers and state employees have complained about their health insurance plan, saying they bear a heavier burden in costs.

Healthcare CostA recently released study supports their argument.

Last week, the consulting firm Aon Hewitt reported that members of the State Health Benefit Plan pay a greater proportion of health care costs than people covered in six comparable employee plans studied — those of five other Southern states’ plans, plus University System of Georgia workers.

The State Health Benefit Plan (SHBP) covers about 650,000 members, consisting of teachers, other school personnel, state employees, retirees and dependents. full story

Merger mania: Aetna to buy Humana

Insurance giant Aetna said Friday that it has agreed to buy rival Humana for $37 billion in a deal that reflects the rampant consolidation in health care.

aetThe acquisition, if approved by shareholders and regulators, will roughly double Aetna’s membership in Georgia.

Connecticut-based Aetna has roughly 700,000 Georgia members in its health plans, while Louisville, Ky.-based Humana covers 692,000 in Georgia.  full story

Alcoholics Anonymous convention hits Atlanta

Chase S. began drinking as a high school freshman in Cobb County.

“I drank pretty heavily,’’ he says now.

int_conv_2015_logoBut just before he turned 18, Chase got sober, turning to Alcoholics Anonymous for help.

“It’s a fellowship program that saved my life,’’ says Chase, now 28.

He’s joining thousands of A.A. members Thursday through Sunday at the  2015 International Convention of Alcoholics Anonymous in Atlanta. More than 60,000 people are expected at the conference, representing 93 countries. full story

Doctors’ suit aims to topple state’s CON rules

Two Cartersville ob/gyns filed suit Tuesday to overturn the state’s health care regulatory process, saying it restricts competition and is unconstitutional.

iStock_000023217379LargeDrs. Hugo Ribot and Malcolm Barfield are challenging the Georgia certificate-of-need program, a complex set of regulations governing the creation and expansion of medical facilities.

The CON process has long been controversial because hospitals often use it to challenge competitors’ proposed projects. It has also pitted doctors against hospitals in battles over building surgery centers.

The physicians’ lawsuit asserts that Georgia’s CON laws “are a restraint on competition, economic liberty, and consumer choice.”

The CON regulations “encourage and facilitate state-granted monopolies and have the effect of restricting competition in the provision of health care services,” the lawsuit says. full story

Consumer Corner

Naps may boost worker productivity

Taking a nap while on the job might help workers be more productive, new research suggests.

Around the State

Medicaid funding challenges

The editor of Stateline discusses prospects for state Medicaid expansion in Georgia, especially in wake of the Supreme Court ruling upholding ACA subsidies.

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Medical mission trip

Seven students from the Georgia campus of the Philadelphia College of Osteopathic Medicine are in Nepal on a medical mission trip.

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Gwinnett Daily Post

Autism coverage required

As of July 1, private insurance companies will provide coverage for the best therapeutic treatment for children with autism ages 6 and under, as a result of a new law.

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Savannah Morning News

Hospital waiting for investor

There’s no news yet about whether a third party investor will save Southern Regional Medical Center in Clayton County.

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Clayton News Daily

DeKalb: Mold complaint

A Doraville mother says her moldy apartment is making her and her children sick.

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