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State Is Years Behind In Reporting Medicaid Program Quality


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Medicaid and PeachCare provide health insurance to about 2 million low-income and disabled Georgians, most of them children.
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Federal law requires states to update their plans for improving Medicaid health care quality at least every three years.
Georgia, however, published its most recent quality plan in February 2016. It’s at least two years out of date.
The guidelines aim to ensure members in Medicaid and the Children’s Health Insurance Program (known as PeachCare in Georgia) get quality health care and state taxpayers get a good return on their investment.
“With the large state investment in Medicaid, the state should have the information it needs to hold the contracted organizations accountable and ensure they are best serving the needs of enrollees,” said Laura Harker, senior policy analyst at Georgia Budget and Policy Institute. ....

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Georgia Reports Much Less Medicaid Data To The Feds Than It Used To


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For the past two years, Georgia reported only a fraction of the information the federal Core Set requested. Finding information about how state insurance plans provide care to people with diabetes is also more difficult this year.
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Nine years ago, Georgia reported ample data to the feds on the health care quality of its Medicaid and PeachCare programs.
In fact, a federal report at that time praised Georgia’s “proactive role in designing its data systems to support quality measurement.”
For seven more years, Georgia continued to be near the top of the data-reporting charts for what’s called the Core Set. It consistently submitted information about how its Medicaid program and its children’s health insurance, or CHIP program (known as PeachCare in Georgia), were delivering care. ....

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