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Georgia’s Medicaid Program Recognized for Exceptional Quality Measurement and Reporting

Posted on November 16, 2011

HHS Secretary Sebelius Spotlights Georgia in 2011 Annual Report

(HealthNewsDigest.com) – ATLANTA – (November 16, 2011) – Georgia’s Medicaid and PeachCare for Kids® programs, under the Georgia Department of Community Health (DCH), have been recognized for Quality Measurement and Reporting. Secretary of Health and Human Services Kathleen Sebelius featured Georgia in the 2011 Annual Report on the Quality of Care for Children in Medicaid and CHIP. Georgia was the only state spotlighted.

Medicaid and the Children’s Health Insurance Program (CHIP) are a major source of health coverage for low-income children ranging in age from infancy to early adulthood. Together, these programs provide coverage for about 40 million children nationally each year with access to a comprehensive set of benefits, In Georgia, these preventive, primary care and other medically necessary services are provided to more than 200,000 children enrolled in PeachCare for Kids. Together with Medicaid, these programs provide health coverage to nearly 1.7 million Georgians.

“Georgia reported 18 of the initial 24 CHIPRA measures in FY 2010, more than any other state,” the report said. “Moreover, the state actively uses the quality measures to assess Managed Care Organizations’ achievement against targets, develop performance improvement plans, and enforce contractual provisions related to quality of care. Georgia has taken a proactive role in designing its data systems to support quality measurement at the state level.”

Georgia was the only state featured in the State Spotlight section of the report. In addition, the state was also credited with an 85% increase in the number of children receiving preventable dental services from federal fiscal year 2000 to 2009.

“Georgia Medicaid and PeachCare for Kids programs are taking an active role in providing access to affordable health care for our underserved and uninsured Georgians,” said DCH Commissioner David A. Cook. “Much of our program success is due to the forward-thinking, results-oriented and innovative leadership demonstrated by our Medicaid team.”

Leading-Edge Programs

Janice Carson, MD, Deputy Director of Performance, Quality and Outcomes with the Georgia Department of Community Health (DCH), provided feedback to CMS on the specifications for the CHIPRA Initial Core Set Measures and participated in the selection of the Adult Core Set Measures that will be released by CMS in 2012. Dr. Carson has also been instrumental in creating several programs directly tied to improving health outcomes – the DCH Planning for Healthy Babies(SM) Initiative, designed to reduce the incidence of low birth weight and very low birth weight babies; and the DCH Patient-centered Medical Home Initiative, a primary-care oriented approach that organizes care around patients and requires providers to work in teams, coordinating and tracking care over time.

Additionally, Medicaid Deputy Director Jon Anderson recently initiated a program with the Social Security Administration to electronically verify citizenship of applicants to PeachCare for Kids. The Department has also received a $2.5 million grant from HHS to revamp and streamline the enrollment and renewal process for PeachCare for Kids. Work made possible by the grant will be implemented over the next 12 months.

“Programs such as these that incorporate technology can streamline administrative processes and increase cost-effectiveness,” said Georgia Medicaid Chief Jerry Dubberly. “Being singled out by Secretary Sebelius is a further testament to our very real commitment to the delivery of quality health care to the people of Georgia.”

DCH is currently undergoing a comprehensive Medicaid Redesign including a complete review of its Medicaid and PeachCare for Kids managed care initiatives. The goals include DCH’s ability to identify more efficient and effective processes in the administration, oversight and delivery of health care services, overall Medicaid and PeachCare expenditures, and opportunities for increased budget predictability and cost management.

The Annual Report by Sebelius is required as part of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and the Patient Protection and Affordable Care Act of 2010 (PPACA). Its goal is to better measure the quality of health care furnished to children under Medicaid and CHIP.

About the Georgia Department of Community Health

Through effective planning, purchasing and oversight, the Georgia Department of Community Health (DCH) provides access to affordable, quality health care to millions of Georgians, including some of the state’s most vulnerable and underserved populations.

DCH is responsible for Medicaid and PeachCare for Kids,® the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia.

David A. Cook serves as Commissioner for the Georgia Department of Community Health. To learn more about DCH and its dedication to A Healthy Georgia, visit www.dch.georgia.gov.

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