DCH Health Care Delivery Transformation Initiatives

1. State Employee Health Plan - Consumer Directed Care Transformation
(Provider of health care coverage for 670,000 state and school districts employees)

Initiative:

Consolidation of 17 state health plan options and transformation to consumer directed health care
Current procurement underway for 2 statewide health plans that will each provide HSA, HDHP, PPO,HMO, and Medicare Advantage Plan options with strategic pricing to incent consumer engagement in consumer directed care

2. Georgia Medicaid & SCHIP: Quality Strategic Plan for Value Driven Health Care
(Provider of publicly funded health care coverage for 1.4 million)

Quality Strategic Plan developed with input from 17 health care professional organization for managed care members
Includes 46 quality of care delivery, clinical and health care outcome measures for public reporting

3. SCHIP (Peach Care): Public-Private Partnership

Public-Private Partnership with Shriners Hospital: To be announced shortly

4. Health Information Exchange

Four Community Partnerships are recipients for HIE Matching Grants totaling $1 million. Grants are for e-Prescring and Electronic Medical Records
Procurement requirements for DCH health plans now include the provision of health information exchange systems
New Medicaid/SCHIP E-Prescribing initiative: to be announced

5. Health Care Transparency Website for Consumers

Procurement currently underway with over 20 applicants
Consumer focused information on health care quality, costs,and availability
Interactive components providing consumers with the ability to compare resources and understand what may be included in "episodes of care"
Links to established and nationally recognized health education sites

6. Health Disparity Elimination Matching Grants for Community Based Solutions

Matching Grant Program to fund community based solutions for health disparities involving cancer, cardiovascular disease, diabetes and HIV/AIDS. Announce: April 2008 (Minority Health Month)

7. Regional Rural Health Safety Net Initiative

Rural Health Safety Net Initiative to create formal regional partnerships between various types of health care providers (rural hospitals, FQHCs, Community Health Centers, clinicians, etc)
Strategic alignment of financial resources, operational resources, and economic development
Efforts focused on: consolidation of select facility resources, pooling of services, integration of care delivery systems for rural communities, restructuring investment for future facilities, and ensuring the development of a secure rural health safety net

8. Health Insurance Partnership for Small Businesses and Sole Proprietorships

3 Share Model to provide access to an affordable health insurance coverage for employees with annual incomes under 300% of fpl. Incentive levels are tiered based on employee income level.
Employees with higher incomes may also purchase health coverage in this program WITHOUT the government incentive
Focus: Commercial health plans provision of consumer directed products (HSA, HDHP) as well as limited benefit plans and full comprehensive plan options
3 Share Model provided via an 1115 Medicaid Waiver. The 3rd Share government incentive for lower income employees consists of state and federal matching (40/60).