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Presentation to: DCH Board

Medicaid Financial Update. Presentation to: DCH Board. June 14, 2012. Mission The Georgia Department of Community Health We will provide access to affordable, quality health care to Georgians through effective planning, purchasing and oversight. We are dedicated to A Healthy Georgia.

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Presentation to: DCH Board

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  1. Medicaid Financial Update Presentation to: DCH Board June 14, 2012

  2. Mission The Georgia Department of Community Health We will provide access to affordable, quality health care to Georgians through effective planning, purchasing and oversight. We are dedicated to A Healthy Georgia.

  3. Top 10 Categories of Service (in Payments) Includes Medicaid and PeachCare Fee-For-Service Only Does not include Crossover claims

  4. Total Number of Claims Paid Includes Medicaid and PeachCare Dates of Service 07/10 - 01/12; Dates of Payment 07/10 - 04/12

  5. Top 10 Fee-For-Service Hospital Payments

  6. Care Management Organization Payments

  7. Georgia Medicaid in SFY 2011 The ABD Population accounts for 25% of Medicaid enrollment, but 54% of Medicaid spending in FY 2011. ABD FY 2011 Total Cost of Coverage * = $4.1B *Total Cost of Coverage includes Net Payment, Capitation Amount and Administrative Fees

  8. Budget and Projected Expendituresby Program FY12

  9. Medicaid Expenditures & EnrollmentFY1996 – FY2019 (ACA included)

  10. Preliminary Budget RequestAmended FY2013

  11. Incurred But Not Reported (IBNR) The chart below represents the amount of IBNR as well as the projected percentage of the amount paid by month.

  12. Historical Medicaid State Fund Expenses ($M)

  13. Affordable Care Act Impact

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