The timeline is still in flux for the state’s highly anticipated decision on a new structure for Georgia Medicaid and PeachCare. The Department of...

The timeline is still in flux for the state’s highly anticipated decision on a new structure for Georgia Medicaid and PeachCare.

The Department of Community Health was scheduled to decide this month on a ‘‘redesign’’ structure for the two government insurance programs.

But officials say they need more time to select the best option for Medicaid and PeachCare, which together cover about 1.7 million Georgians. No new decision date has been set.

The pending U.S. Supreme Court ruling on the Affordable Care Act has added ‘‘a great deal of uncertainty’’ to the process, Blake Fulenwider, deputy commissioner of Community Health, told the agency’s board Thursday.

That law, if upheld by the court, is expected to add more than 650,000 Georgians to the Medicaid rolls.

A recent state-funded report by a consulting firm recommended an enhanced managed care program for Medicaid. The recommendations include placing the elderly and people with disabilities into managed care for the first time.

State officials emphasize that advocacy groups and medical provider organizations have been actively involved in the decision-making about the redesign. Three task forces –- on providers; the aged, blind and disabled population; and children and families –- have produced many proposals for revamping the insurance programs.

“The level of engagement that we’ve seen is tremendous,’’ Fulenwider said. “Stakeholders have made clear they want us to slow down’’ the process, he added.
Jerry Dubberly, the state’s Medicaid director, said the common themes that stakeholders have cited include:

* Improving access and developing a strong primary care infrastructure.

* Simplifying the administrative processes involved in the two programs.

* Having uniform procedures for pre-certification of medical procedures.

* Pushing for a provider-driven ‘‘medical home’’ model of care.

* Focusing on quality and outcomes of care.

* Ensuring proper oversight.

* Integrating the physical and behavioral health of members.

* Enhancing mental health and substance abuse services.

“ ‘One size does not fit all’ is a message we’re hearing,’’ Dubberly said.

“We’re approaching this to do it right, not fast,’’ he added.

 


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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