Georgia's Trusted Healthcare
& Medical Provider Attorneys

Archives for July 2013

Georgia to Hire Private For Profit Company to Oversee Medical Care of Foster Children

Streamlined Managed CareThe state is planning to streamline the medical care of children in foster care, adoption assistance or the juvenile justice system by transitioning to a managed care model.

Currently, the change in the living situation of these children may result in a change in doctors and incomplete medical records, which can ultimately result in complications when doctors are not aware of medical history or allergies.

Under the managed care model, the children will have one primary care physician and their records will be stored electronically, allowing for continuity of care and access to information regardless of where the child is living.

In addition to potentially saving the state $27.5 million over five years, the move to managed care may result in healthier children. Other states using the managed care model for foster children have reported decreases in the use of psychotropic medication and increases in health risk screenings.

Georgia plans to hire one of the three for-profit care management organizations in the state that currently oversee the provision of care to children and pregnant women who receive Medicaid.

Further, a quarterly oversight committee will be established that is comprised of representatives from several agencies to monitor the progress under the managed care model.

The managed care model for children in foster care, adoption assistance or the juvenile justice system may potentially provide less confusion for physicians and a greater continuity of care for children.

Medicare Trustees Report Includes Promising News for Healthcare Providers and Beneficiaries

Healthcare Cost SavingsThe Medicare Trustees recently released their 2013 Report, and it contained some promising news for the Medicare Hospital Insurance Trust Fund.  The Fund will be able to cover its obligations until 2026, which is an extension of last year’s projection by two years.

The increased solvency of the Trust Fund is good news for both healthcare providers and beneficiaries because it points to the positive financial impacts of current efforts to reduce healthcare spending.  Additional good news for beneficiaries included a preliminary estimate of the Part B premium for 2014, which is unchanged from 2013.

The CMS Administrator attributes the increased solvency of the Trust Fund to the Affordable Care Act; however, the Report cites numerous contributing factors, such as lower 2012 Part A spending and potentially lower Medicare Advantage costs.

Opponents of health care reform stress that crediting the Affordable Care Act for the increase in solvency may be premature because the numbers depend on a range of factors, none of which are fully predictable at this stage of implementation.

The actual impact of the Affordable Care Act provisions remains to be seen as does the implications to the Trust Fund.  Providers should stay informed about the potential financial impacts of healthcare reform as provisions are implemented in the coming months.