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Medicaid

A tale of two (neighboring) hospitals

Piedmont Fayette Hospital is expanding its emergency room capacity to keep up with Fayette County’s growth and rising patient numbers.

Fayette County

Fayette County

The $40 million project will also add more beds to the hospital, located in Fayetteville, south of Atlanta.

More than 61,000 patients were treated in the hospital ER last fiscal year, but Piedmont Fayette officials expect the number to exceed 67,000 this year.

“We’re at capacity now, and this will help us better serve our patients,” CEO Michael Burnett said last week. And he announced that the hospital wants to add even more capacity in the near future.

Many Georgia hospitals are reeling financially from the high costs of uncompensated care, because they are treating so many uninsured patients. full story

Reese: ‘Waiver’ doesn’t need new legislative OK

The head of a state health agency reiterated his position Thursday that Georgia already has the authority now to pursue a Medicaid “waiver” plan to cover uninsured people.

Clyde Reese

Clyde Reese

That statement by Clyde Reese, commissioner of the Department of Community Health, runs counter to arguments made in a recent letter from Rep. Jason Spencer and other state legislators.

The letter asserted that the recent legislative budget provision permitting such a waiver is not sufficient, and that the General Assembly needs to pass a new, separate bill or resolution to allow such a step.

Spencer, a Woodbine Republican, has raised questions about a plan proposed by Grady Health System that would request a special 1115 waiver, an experimental plan that the feds approve to give states flexibility to improve their Medicaid programs by using a new approach.

Reese, an attorney himself, said the budget line item allowing a waiver process in the fiscal 2016 state budget — passed by the General Assembly — “constitutes legislative approval for the submission of the 1115 waiver.’’ He added that Gov. Nathan Deal agrees with him on this point. full story

Feds make financial pitch for Medicaid expansion

The Obama administration rolled out new statistics this week to buttress the argument that Georgia should expand its Medicaid program.

1088819262-1249The report from the White House Council of Economic Advisers said that if Georgia expanded Medicaid, as outlined by the Affordable Care Act:

** An additional 389,000 Georgians would have insurance coverage in 2016.

** 52,000 additional Georgians would report being in good (or better) health and 36,000 fewer individuals would experience symptoms of depression.

** 55,300 fewer people would have trouble paying other bills due to the burden of medical costs.

The report also estimates that by not expanding Medicaid, Georgia will miss out on $2.85 billion in federal funding in 2016.

The White House report included similar estimates for other states that have not expanded Medicaid. While expansion is called for by the ACA, the U.S. Supreme Court ruled in 2012 that the decision is up to the individual states. full story

Official who ‘helped stabilize’ DCH finances retiring

When he took over as finance chief for the state Department of Community Health, Tim Connell assumed oversight of a $13 billion budget.

Tim Connell

Tim Connell

The agency administers Medicaid, a highly complicated, vital health program, as well as the benefits plan for state employees and teachers.

Connell didn’t have health care experience when he took the job. What he did have was years of state government financial work, including as president of the Georgia Student Finance Commission. He spent two years as director of the Governor’s Office of Planning and Budget, and also was deputy commissioner for the Georgia Department of Community Affairs for six years.

“The reason why I came to DCH was to apply a management approach’’ used in previous positions, Connell told GHN in a recent interview. He said his goal was to improve the overall accountability and effectiveness of the agency’s financial operation.

Connell, 65, is retiring at the end of June after more than 35 years of government service, with the past two at Community Health.  full story

Georgia nursing homes fairly low in quality report

Nearly half of Georgia nursing homes have relatively low ratings  — either 1 or 2 stars out of a possible 5, according to a report analyzing quality scores for these facilities nationally.

The Kaiser Family Foundation, using the quality scores from the “Nursing Home Compare’’ website of the federal Centers for Medicare and Medicaid Services, found that Texas has the worst record. Among Texas nursing homes, 51 percent received a 1 or 2 rating.

nhomesThe Lone Star State’s ratings were followed by Louisiana, with 49 percent of nursing homes with a 1 or 2, and then Georgia, Oklahoma and West Virginia at 46 percent, said the report, released last week.

The study found that nationally, 36 percent of nursing homes certified by Medicare or Medicaid have overall ratings of 1 or 2 stars.

A larger share of nursing homes — 45 percent — have overall ratings of 4 or 5 stars. Georgia’s percentage of 4 or 5 star facilities, however, is 32 percent.

“Once again Georgia is at the bottom of the barrel on quality, but there is no simple solution,’’ said Kathy Floyd, executive director of the Georgia Council on Aging, when asked Monday by GHN to comment on the report. full story

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