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Medicaid

Navigators aided consumers in need, report shows

Consumers in Georgia and three other states who were helped by navigators for the 2014 insurance exchanges tended to be people of color who were not financially secure, a recently released report says.

Navigators, who are specially trained in the provisions of the Affordable Care Act, provide face-to-face, in-person help for consumers seeking information about health insurance policies in the state exchanges, also called marketplaces.

The report by the University of Georgia also said many consumers helped by Seedco navigators in the four states had limited knowledge about health insurance concepts.

Sidney Wood meets with navigator Amanda Ptashkin in March.

A consumer meets with Atlanta-based Seedco navigator Amanda Ptashkin in March.

Seedco, a nonprofit group, was the lead organization in Georgia supplying navigators during the last Open Enrollment period for the ACA insurance exchanges. It also provided these counselors in Tennessee, New York and Maryland, and will do so again in the new enrollment period, which starts next month.

A UGA unit was the second Georgia navigator grantee group last year, but it is barred from participating this time by a newly passed state law. Top Georgia officials have been strongly critical of the ACA and have worked to limit official state involvement in its programs.

The UGA report found that among consumers in the four states helped by Seedco navigators, almost two-thirds (64.5%) were people of color. African-Americans were especially prevalent among these Georgia consumers. About 10 percent of consumers preferred to speak a language other than English. full story

Poll: Georgians like expansion, but not ACA overall

A new poll finds 60 percent of Georgians disagree with the state’s decision not to expand the state’s Medicaid program, a key provision of the Affordable Care Act.

The health reform law overall, though, fares less well in popularity. According to the survey, conducted by the Schapiro Group in August and sponsored by Healthcare Georgia Foundation, 42 percent of Georgians approve of the ACA and 46 percent disapprove.

Healthcare CostThe survey also found that the cost of care continues to be an important factor in whether consumers receive health care. Forty-two percent of Georgians said they wanted to seek care at some point, but chose not to do so, up from 33 percent the year before. Cost was the most cited reason for that decision.

And 40 percent of the 400 respondents said they think they have paid more for care over the past year.

“As the troubling trend of increased health care costs continues, Georgians who cannot afford health insurance are simply unable to seek or choosing not to seek the medical care they need,” said Gary Nelson, president of Healthcare Georgia Foundation. full story

Medicaid fee funds preserved after brief scare

A Medicaid fee that brings in $31 million in federal funds for Georgia’s private hospitals was nearly sidetracked Tuesday because of the opposition of one member of the board of the state Department of Community Health.

Piedmont Atlanta Hospital

Piedmont Atlanta Hospital

The board member, former Gwinnett County legislator Clay Cox, agreed to reverse himself after it was pointed out that his “no” vote could effectively kill that portion of the state’s hospital provider fee, an important funding mechanism for Medicaid.

The Community Health Board ended up giving initial approval to the hospital provider fee and is expected to adopt it at the board’s November meeting.

The hospital provider fee – sometimes referred to as a “bed tax” – is collected from Georgia’s hospitals by Community Health. full story

Nursing home rate change put on hold

A health agency commissioner Thursday pulled off the table a controversial rate change that would benefit the state’s nursing home industry.

DCH Commissioner Clyde Reese

Clyde Reese

It was designed to pay extra money to companies that bought Georgia nursing homes between Jan. 1, 2012, and June 30 of this year, because of the costs that new owners bear in upgrading the facilities.

Clyde Reese, commissioner of the Department of Community Health, told the agency’s board that he wants to spend more time reviewing the rate hike.

The payment idea, Reese said, has “definite merit.’’ But he said he would like to change the methodology so that it would reward a broader range of nursing homes, with faster reimbursement, for upgrades they make. full story

Freestanding ERs target suburbs, rural panel told

Freestanding emergency departments have been proposed in Georgia as a potential solution for struggling rural hospitals, or newly closed ones, that want to remain operational in downsized form to help patients in need.

Healthcare CostBut the trend toward such standalone emergency rooms nationally is totally different from that picture, members of the Georgia Rural Hospital Stabilization Committee were told Monday.

Freestanding EDs are actually proliferating in suburban areas, targeting high-income patients who have private insurance, said Charles Horne of accounting firm Draffin & Tucker. The prevailing emphasis is on patient convenience, not need, he told committee members at a meeting in Cordele.

Earlier this year, Gov. Nathan Deal backed a change in state licensing rules that would permit a stand-alone emergency department and some other services in rural areas that have a financially ailing – or closed – hospital.

But so far, no organization has applied to create such a facility in the state.

Meanwhile, four rural hospitals have closed in the past two years in Georgia, and others are having severe financial problems. full story

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