11:23:18 PM PDT - Monday, September 27th, 2021

Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care?  

By Editor - Mon Sep 13, 3:18 am

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Just before Frank Berry left his job as head of Georgia’s Medicaid agency this summer, he said the state “will be looking for the best bang for the buck” in its upcoming contract with private insurers to cover the state’s most vulnerable. But whether the state — and Medicaid patients — are getting an optimal deal on Medicaid is up for debate. Georgia pays three insurance companies — CareSource, Peach State Health Plan and Amerigroup — over $4 billion in total each year to run the federal-state health insurance program for low-income residents and people with disabilities. As a group, the state’s insurers averaged $189 million per year in combined profits in 2019 and 2020, according to insurer filings recorded by the National Association of Insurance Commissioners. Yet Georgia lacks some of the financial guardrails used by other states. “Relative to other states, Georgia’s Medicaid market is an attractive business proposition for managed-care companies,” said Andy Schneider , a professor at Georgetown University’s Center for Children and Families.

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Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care?

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