Subscribe to The Pulse

Medicaid

Most in state health plan pick Blue Cross

Blue Cross and Blue Shield of Georgia will remain the dominant insurer for the state’s high-profile employee health plan.

More than 80 percent of State Health Benefit Plan members selected insurance plans from Blue Cross during its recent open enrollment, a state agency said Thursday.

Clyde Reese

Clyde Reese

Blue Cross was the sole insurer offering plans for the 2014 coverage year.  Through public criticism, rallies and a Facebook campaign, many state employees and teachers in the SHBP sought more choices of health insurers for their 2015 coverage.

The state then added two insurers, Kaiser Permanente and UnitedHealthcare,  to the offerings of health plans for next year.  They will share the remaining state health plan members.

The SHBP covers more than 650,000 state employees, teachers, other school personnel, retirees and dependents.

The Department of Community Health’s commissioner, Clyde Reese, announced the enrollment numbers at the agency’s board meeting Thursday. full story

Sagging rural hospital tries to get an urban boost

A struggling rural hospital in east-central Georgia hopes to gain firmer financial footing  through a new partnership with University Health Care System in Augusta.

University Health Care will manage Washington County Regional Medical Center in Sandersville beginning Jan. 1, under an agreement announced Monday.

univSuch rural hospitals and their survival have been a focus for political leaders in Georgia after the closure of four of these facilities in the past two years.

Jimmy Lewis of HomeTown Health, an organization of rural hospitals in Georgia, said recently that besides the four closures, 15 more facilities are “financially fragile.” Six of those, he said, “could go tomorrow due to low cash.”

Those financial pressures led Gov. Nathan Deal to appoint a Rural Hospital Stabilization Committee, which last week concluded its hearings with a public comment period.

Earlier this year, Washington County Regional Medical Center  discontinued non-emergency baby deliveries because of financial losses, joining the more than 40 hospitals in rural areas in Georgia that have given up deliveries due to costs. full story

State Medicaid chief stepping down

Jerry Dubberly is leaving his position as Georgia’s Medicaid director, effective Jan. 2.

Jerry Dubberly

Jerry Dubberly

He’s stepping down from what experts consider a vitally important job in Georgia health care.

As Medicaid chief, Dubberly oversees the services for about 1.9 million Georgians in Medicaid and PeachCare, with a state budget of more than $2.5 billion.

Dubberly could not be reached for comment.

The Department of Community Health said in an email statement to GHN that Commissioner Clyde Reese is working on filling the vacancy.

It’s difficult to find someone to do the job well, experts say. full story

State panel meets over ailing rural hospitals

Struggling to stay afloat financially, a northwest Georgia rural hospital has opted to file for bankruptcy protection from its creditors.

Officials at Hutcheson Medical Center in Fort Oglethorpe said Wednesday evening that the filing would allow it to continue operations, restructure debt, and help protect it from a Chattanooga system’s effort to foreclose on the hospital’s property.

Erlanger Health System has tried to recoup about $20 million it loaned Hutcheson as part of a management agreement.

Hutcheson Medical Center

Hutcheson Medical Center

The bankruptcy action came just hours before Gov. Nathan Deal’s Rural Hospital Stabilization Committee met in Lavonia on Thursday at Ty Cobb Regional Medical Center — another rural hospital experiencing severe financial challenges.

The panel heard speakers outline the depth of the state’s rural health care crisis.

Four rural hospitals have closed in Georgia over the past two years. Jimmy Lewis of HomeTown Health, an organization of rural hospitals, told the committee that 15 more facilities are “financially fragile.” Six of those, he said, “could go tomorrow due to low cash.”

“We’re approaching Third World care in the state of Georgia,’’ Lewis said.

More than 40 Georgia counties lack obstetrical providers, and just 75 of 180 hospitals in the state have labor and delivery units, Pat Cota of the Georgia OB/GYN Society told panel members. full story

Latest ACA court case reverberates in Georgia

The U.S. Supreme Court’s decision Friday to take up a case challenging the subsidies in the Affordable Care Act’s exchanges could wind up having a huge impact in Georgia.

The federal subsidies help millions of Americans afford health insurance offered in the exchanges, which were created as part of the health reform law.

The U.S. Supreme Court made Medicaid expansion optional for states..

According to the plaintiffs, those subsidies are improperly being given in the more than 30 states, including Georgia, that have decided not to run their own insurance exchanges. The federal government runs the exchanges in those states.

If the Supreme Court strikes down subsidies in federally run exchanges, it almost certainly would cause those marketplaces to collapse unless the states step in to run them.

In Georgia, however, that is not legally possible. This year, the Georgia General Assembly passed legislation that bars the state from running an ACA exchange. That prohibition was among other anti-Obamacare provisions that were signed into law. full story

  • Sign up for our mailing list.