Atlanta - Facing the addition of hundreds of thousands of new enrollees to Georgia's Medicaid system, the state is re-examining the program - searching for more cost-effective ways to provide care.
Medicaid is already facing a $180 million shortfall this fiscal year; meanwhile, officials say the 600,000-plus people expected to join its rolls under the federal health care overhaul starting in 2014 could cost the state an additional $2.1 billion by the end of this decade. Medicaid and PeachCare for Kids currently provide health care to roughly 1.7 million low-income Georgians.
The state Department of Community Health plans to hire a consultant to evaluate the $6 billion-plus program and identify potential options to redesign it, as well as study ideas emerging in other states. A complete review is expected by year's end.
While providers welcome efforts to improve the program, some worry it may be a way for the state to cut costs at the expense of patients and doctors.
Without more funds, the state would likely need to look at cutting services or reimbursements to medical providers, said Tim Sweeney, a health care analyst with the Georgia Budget and Policy Institute. States across the country are already cutting Medicaid spending, including Georgia, which reduced payments to medical providers by 0.5 percent and increased co-pays this year.
Jerry Dubberly, the state's Medicaid division chief, however, said Georgia's goal is to find cost-effective ways to deliver care while improving health outcomes and quality of care as it faces challenges with the impending Medicaid expansion. Funding is one major issue.
Under the expansion -- which will extend eligibility to people under age 65 with incomes up to 133 percent of the poverty level -- the federal government will pay 100 percent of the costs from 2014 to 2016. Federal funding will then ramp down to 90 percent by 2020, where it will remain.
In fiscal year 2011, the state paid roughly $1.7 billion for Medicaid and PeachCare, with the feds providing an additional $5 billion.