DCH: Will have Medicaid decision by ‘this summer’


The Department of Community Health said Monday it expects to make a decision about the redesign of Medicaid and PeachCare by “this summer,” an extension of the original timeline for revamping the health insurance programs that spend nearly $8 billion in state and federal funds annually.

“We expect to announce our decision about the new delivery model for the Medicaid and CHIP redesign this summer,” DCH Commissioner David Cook said in a statement released by the department.

“We are extremely pleased that Medicaid stakeholders from around the state have provided significant input that is being fully evaluated,” Cook said. “We are also doing extensive data and financial modeling of the various options for Medicaid going forward.”

DCH last year commissioned a study by the Chicago-based firm Navigant Consulting of alternatives for revising the state’s system for providing medical care to low-income and working class families.

Navigant’s report, which was released in January, recommended that DCH retain the current managed care model that covers the majority of Medicaid patients but expand it to include the aged, blind and disabled population. Navigant also said the department should move some of the program’s participants into a “commercial” model of health insurance coverage.

When the Navigant recommendations were first unveiled in January, Cook said he hoped to have the changes in the Medicaid program implemented by the end of the fiscal year on June 30.

That timeline has now been pushed back to where department officials say the announcement of the final program design will be made this summer, which then would require several additional months for implementation.

Cook has cited the federal Affordable Care Act (ACA), also known as Obamacare, as a major factor in the need for a Medicaid revamp. Under ACA, an estimated 650,000 additional Georgians would be eligible for Medicaid coverage and could push the program’s projected deficit to as much as $600 million a year.

The U.S. Supreme Court is expected to rule on the constitutionality of the federal healthcare act at some point during June, however, and could possibly overturn the entire law, which would presumably eliminate that influx of persons eligible for Medicaid.

“DCH is fully aware of the impending U.S. Supreme Court decision regarding the Affordable Care Act,” Cook said. “We are taking all possibilities into consideration as we weigh our options against our goals and strategies.”

Regardless of which way the Supreme Court rules, a momentous revision of the Medicaid program is looming for Georgia’s hospitals and healthcare professionals.

Jimmy Lewis, a lobbyist for a group of rural hospitals called HomeTown Health, cautioned in a recent email to his members: “A recent visit to seven rural hospitals by HomeTown and several policymakers indicated that the Medicaid system continues to be very fragile and the magnitude of change that can come with this Medicaid Redesign will severely damage access to health care in rural Georgia.”

© 2012 by The Georgia Report


Tags: ACA , David Cook , DCH , Medicaid , Navigant , PeachCare , redesign