Subscribe to The Pulse

Health Insurance

Atlanta’s Piedmont system landing new hospital

Just two days after WellStar announced plans to add another hospital, a second metro Atlanta health system says it’s making a similar deal.

Atlanta-based Piedmont Healthcare said Thursday that it plans to bring Newton Medical Center in Covington into its group of hospitals.

Newton Medical Center

Newton Medical Center

The deal will involve a long-term lease of assets from the Newton County Hospital Authority, and when the agreement takes effect, Newton Medical will become a subsidiary of Piedmont, officials said.

The announcement follows Tuesday’s news that Marietta-based WellStar Health System aims to take West Georgia Health in LaGrange into its fold. West Georgia Medical Center would become the sixth hospital in the nonprofit WellStar system, though it’s the first one not in Atlanta’s suburbs.

The moves continue the rapid consolidation among hospitals in Georgia and nationally, as they face dramatic changes in the way they’re paid for services. Part of that stems from provisions in the Affordable Care Act.  full story

WellStar expanding reach in LaGrange hospital deal

Marietta-based WellStar is planning to add another hospital system to its fold, one that’s outside its current geographical sweet spot.

West Georgia Health in LaGrange announced Tuesday that it has signed a letter of intent to join WellStar Health System, which dominates the northwest Atlanta suburbs.

West Georgia Health in LaGrange

West Georgia Health in LaGrange

The CEO of West Georgia, Jerry Fulks, cited the changes rampant in health care payments — many of which were ignited by the Affordable Care Act — for his system’s yearlong pursuit of a partner.

West Georgia Medical Center would become the sixth hospital in the nonprofit WellStar system, though it’s the first one that’s not in Atlanta’s suburbs.

Meanwhile, WellStar is still working on a potential blockbuster merger with Emory Healthcare in metro Atlanta.

Fulks said Tuesday that West Georgia Health, the parent of the medical center, was seeking a partner with at least $1 billion in revenues, which WellStar surpasses. “We wanted an organization that’s focused on physicians and employees,’’ Fulks added.   full story

State studying design for Medicaid waiver plan

The state’s main health agency says it’s analyzing a new plan to cover more uninsured Georgians through a special Medicaid “waiver’’ program.

Clyde Reese

Clyde Reese

Gov. Nathan Deal “has asked us to work on it,’’ Clyde Reese, commissioner of the state Department of Community Health, said Thursday.

The plan for a Medicaid waiver was generated by Grady Health System as an alternative to Medicaid expansion under the Affordable Care Act, a step that has been firmly rejected by Deal and state legislative leaders.

The Grady plan focuses on using federal matching Medicaid dollars to help set up pilot sites that would give coverage to the uninsured, then manage their care and potentially improve their health.

Grady in Atlanta, Memorial Health in Savannah, and a small group of rural hospitals are seen as the initial sites in the coverage plan, which has generated much interest and speculation within the state’s health care industry.

Meanwhile, a safety-net health system in Cleveland, Ohio, told GHN that a similar program there –- cited as a model for the Grady plan -– helped improve many patients’ health and was carried out at costs below budget estimates. full story

Grady outlines plan to transform care for uninsured

Grady Health System realized it couldn’t count on Medicaid expansion anytime soon, so it went looking for a different path.

Expansion, already implemented in a number of other states, would have extended coverage to hundreds of thousands of low-income Georgians – turning them into paying patients. By doing that, it would have helped Atlanta’s Grady Memorial and other hospitals offset deep federal cuts looming from the Affordable Care Act.

But Gov. Nathan Deal and the Republican-led Georgia General Assembly stood firmly opposed to expanding Medicaid because of the cost.

Grady Memorial Hospital

Grady Memorial Hospital

So Grady officials began to envision a smaller-scale insurance program that could avoid the political and financial pitfalls that accompany a Medicaid initiative.

What they and state officials are proposing is a plan where federal matching Medicaid dollars would be used to help set up pilot sites that would give coverage to the uninsured, then manage their care and potentially improve their health.

Grady in Atlanta, Memorial Health in Savannah, and a small group of rural hospitals are seen as the initial players in the coverage plan. full story

Autism coverage becomes law with signing

Just a month ago, the latest attempt to require autism coverage in Georgia insurance policies appeared dead.

Autism legislation was stuck in the House Insurance Committee in the waning days of the 2015 General Assembly session. Similar bills that had been proposed in previous years had stalled and ultimately failed.

Gov. Nathan Deal signs House Bill 429 as legislators and Ava Bullard (in green dress) look on.

Gov. Nathan Deal signs House Bill 429 as legislators and Ava Bullard (in green dress) look on.

But this time, a compromise between House and Senate leaders led to a reworked insurance bill that added the autism requirement language. The legislation was passed.

And on Wednesday, flanked by legislators and child advocates at the state Capitol, Gov. Nathan Deal signed House Bill 429 into law.

It will require many health insurance plans to cover applied behavior analysis (ABA), a treatment designed to help young children with autism reach their full potential in learning ability. The legislation applies only to children 6 and under, and does not require coverage by large companies that self-insure their benefits. full story

  • Sign up for our mailing list.