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Medicaid Redesign and Georgia’s Children

Medicaid Redesign and Georgia’s Children. Danté T. McKay Associate Policy Director, Child Health January 4, 2012. Managed Care in Georgia. Articulated Goals: More efficient delivery of health care services Better care for members Accountability to taxpayers

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Medicaid Redesign and Georgia’s Children

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  1. Medicaid Redesign and Georgia’s Children Danté T. McKay Associate Policy Director, Child Health January 4, 2012

  2. Managed Care in Georgia Articulated Goals: • More efficient delivery of health care services • Better care for members • Accountability to taxpayers • Predictable and sustainable growth for the Department of Community Health (DCH)

  3. Georgia Families CMOs: • AMERIGROUP Community Care • Peach State Health Plan • Wellcare of Georgia, Inc. Included Populations: • Peach Care for Kids (PeachCare) • Low Income Medicaid • Right from the Start Medicaid • Breast and Cervical Cancer Excluded Populations: • Aged, Blind, Disabled • Foster Care • Nursing Home

  4. Assessing Managed Care in Georgia DCH’s reasons for assessing managed care in Georgia: • To ease administrative burdens • Enhance efficiencies • Promote access and improve outcomes in a fiscally responsible way

  5. Medicaid Redesign Navigant Consulting Inc. tapped to: • Conduct environmental scan • Recommend options for innovative redesign or modification • Assist with the procurement process and implementation Navigant’s work is expected to address: • Most appropriate approach • Access and quality • Administrative efficiencies • Budget predictability and cost management • Service gaps and program weaknesses

  6. Medicaid Redesign Voices for Georgia’s Children and Georgians for a Healthy Future tapped Kellenberg Consulting to: • Conduct an independent children’s-focused environmental scan on a national and Georgia-specific basis • Recommend options for innovative redesign or modification for improving coverage, access, and quality for Georgia’s children

  7. Medicaid Redesign Research Findings: • Further simplification measures would increase coverage of eligible but uninsured children • Increasing administrative efficiencies requires modernized eligibility systems • Pediatric specialty access gaps exist • Georgia Medicaid and PeachCare quality monitoring is strong, but child quality performance indicators point to a need for improvement • Medical homes are an essential component of a quality-driven delivery system

  8. Thank You! For more info: Danté T. McKay (404) 521-0311 dmckay@georgiavoices.org www.georgiavoices.org

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