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Officials careful about Medicaid revamp

State officials who intend to redesign Georgia's $7.8 billion Medicaid program are facing significant challenges because of the program's expanded role. No longer is the program, along with Social Security Disability, providing only medical care. Rather, the programs are now rehabilitative, delivering job training and other important services for low-income residents.

Georgia residents who suffer from developmental disabilities and mental illnesses receive a large number of benefits from the existing program provisions, as do foster children and people who are disabled. Many of the disabled individuals also often qualify for SSD benefits in conjunction with Medicaid. But it's important to remember that no one is living the high life on these benefits. These are necessary to get by.

Even though these populations only account for about a fourth of Medicaid patients throughout the state, their complicated cases consume about half of Georgia's resources allocated for the program each year. Furthermore, recent abuse scandals have prompted an increased push to remove mentally ill and disabled residents from state hospitals. As a solution, the state is considering using for-profit Medicaid service management groups. Those entities would ensure that Medicaid money is being fairly distributed and efficiently spent, according to estimates from Georgia lawmakers.

More than 1 million Georgians currently receive Medicaid, with the majority of those being children and low-income pregnant women. The managed care concept already is applicable to those groups, but Georgia policymakers are considering expanding the practice to the more than 400,000 elderly and disabled program beneficiaries.

Paramount in the decision is the responsibility of the state to ensure that its citizens receive appropriate care. Still, lawmakers contend that Medicaid reforms would benefit everyone, allowing those who really need additional interventions to receive the care they require.

State officials are making a concerted effort to listen to advocates for the special populations, especially those related to disabled and elderly Georgians. Managed care could provide a more comprehensive and understandable treatment plan for many disability recipients, who currently cost the state about three times as much as other Medicaid beneficiaries.

Source: The Atlanta Journal-Constitution, "Medicaid more than medical aid," Misty Williams & Carrie Teegardin, June 4, 2012.

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