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Georgia Health Policy Center1
at the Andrew Young School of Policy Studies
The Health Policy Center conducts research for the development of health care policy recommendations and implementation strategies for improving the health care delivery system in Georgia. Through studies, research and public debate, staff of the Health Policy Center and representatives from collaborating organizations assist in the formulation of health care policy. The 1999 projects of the Health Policy Center included the following subject areas: rural health, long term care services, and policy development, evaluation, and program implementation efforts with the Department of Community Health, Division of Medical Assistance. Several other initiatives are listed below under a general project category. James Ledbetter is the Director of the Health Policy Center.
In This Page
Projects
Rural Health Project
Rural Health Development. Karen Minyard. The Policy Center works with fragile health care systems in rural communities throughout the state. The contract is a three-year effort to strengthen the health care infrastructure in ten new communities each year. This project involves monitoring changes in the healthcare market, identifying fragile communities, developing community strategic health care plans, conducting business evaluations of the existing health care providers in the community, determining those services that are clinically appropriate and financially viable, and providing technical assistance for the implementation of those plans. The state Office of Rural Health in the Department of Human Resources has identified the Health Policy Center as the lead agency in the management of the network development component of the application submitted to the Robert Wood Johnson's Southern Rural Access Program. Technical assistance capacity in hospital authority management, financial management of rural hospitals and physician assessment of clinically appropriate services is being developed. The program will aid local communities in restructuring their health care systems for future strength and in identifying appropriate relationships with regional, tertiary systems of care. ($1,000,000)
The Health Policy Center sponsored the Networks for Rural Health Annual Conference held in Macon, Ga. December 7, 1999.
Long Term Care Services Projects
Improving Care at the End of Life. James P. Cooney, Jr. and Glenn M. Landers. Improving care at the end of life (CEOL) is a topic that is taking on greater importance nationally and in Georgia, stimulated both by the aging of the American population and the increasing technological capacity of clinical care. There is an increasing recognition of the disconnect that exists between the care that people want, and the care they receive.
The Health Policy Center is managing a statewide Collaborative on Improving Care at the End of Life. Support for this initiative comes from the Department of Community Health's Division of Medical Assistance, the Georgia Coalition for Health, Inc., and the Joseph P. Whitehead Foundation. This effort included the pilot testing of materials developed by Georgia Health Decisions to increase citizens' use of advance planning directives in eight communities throughout Georgia. The Health Policy Center staff is conducting the evaluation of the demonstration pilot sites. Additionally, the Health Policy Center is partnering with the Georgia Medical Care Foundation to develop quality intervention strategies for long-term care services to improve the continuity of care and promote the presence of, and compliance with, patients' advance directives. Center staff in collaboration with the four Georgia-based medical schools is currently assessing their undergraduate curricula to identify needs for expanding the palliative care components. As an extension, the Center is also working with the schools in their use of the AMA's Education for Physicians on End of Life Care (EPEC) program for continuing education of practicing physicians in advanced illness and palliative care areas. All of the Center's CEOL efforts provide building blocks for a comprehensive education program for health care providers and the general public, care at the end of life policy development for both the public and private sectors, and statewide replication. ($878,000)
Implementation and Testing of Pre-admission Screening for Long Term Care Services. James P. Cooney, Jr. and Glenn M. Landers. The Center developed a statewide information system to facilitate the matching of individuals with disabling chronic conditions to appropriate service and skill levels of long-term care services. The prototype system, funded by the Department of Community Health's Division of Medical Assistance was developed with the assistance of an external advisory committee and completed in June of 1999. It is anticipated that the Center will oversee the field testing of the prototype system. ($100,000)
Chronic Conditions: Mapping the Georgia Population. James P. Cooney, Jr. At the invitation of the legislatively-established Long Term Care Study Commission, the Policy Center developed a model of the Georgia chronic conditions populations. This data-based information system has the capacity to: measure the number of individuals in Georgia whose health status is adversely affected by chronic conditions; describe that population in terms of selected socio-economic, clinical and disability measures; and monitor changes in that population and their long-term care service needs. An advisory sub-committee of the Commission worked with Center staff in the effort. The model was presented to, and accepted by, the Commission in May of 1999; subsequently, the Commission recommended that the state assume responsibility for further implementation and maintenance of the model. The Center's report on the model was incorporated into the Commission's final report to the Governor and General Assembly. ($75,000)
Georgia Long Term Care Study Commission. James P. Cooney, Jr. and Glenn M. Landers. In addition to developing the chronic conditions population model (described above), Center staff facilitated for Commission members the development and implementation of their study agenda and recommendations. Center staff developed the outline of the Commission's final report and wrote the document with Commission review and approval. ($35,000)
Evaluation of Georgia's Community Care Services Program [CCSP]. Glenn M Landers and James P. Cooney, Jr. Under a contract with the Department of Community Health, Division of Medical Assistance, the Center designed and implemented an evaluation of the Medicaid-oriented Community Care Services Program. The evaluation protocol focused on change in the patient population, program management and service capacity needs. The methodology included field interviews of program managers and health care providers and mail-in surveys to a range of program stakeholders. The final report was submitted December, 1999. ($100,000)
Projects Under a Multi-year Contract with the Georgia Department of Community Health's Division of Medical Assistance Related to Policy Development, Evaluation and Program Implementation
Assessing and Improving the System of Care for Children with Special Health Care Needs in Georgia. Jennifer Edwards. The Health Policy Center staff is evaluating the current health care system serving children with special health care needs (CSHCN) to assess problems and opportunities for improvement. Based on their analysis of existing data on health care utilization and interviews with state officials, advocates, families, providers, and others, the HPC staff have developed a model of the current system. They are assessing best practices from other states or model programs, and developing recommendations to the Department of Community Health's Division of Medical Assistance for changes in the delivery and financing of care. In the second year, HPC staff may help the Division implement accepted changes. ($72,000)
Improving Outreach and Community Participation in PeachCare for Kids and Title XIX. Mary Ann Phillips. Health Policy Center staff coordinated several programs related to increasing the enrollment of uninsured children in PeachCare for Kids and Title XIX. These programs included the development of two satellite learning programs to provide PeachCare and Title XIX information and training to several healthcare provider groups around the state, the development, coordination, and monitoring of a competitive process for issuing mini grants to community groups around the state to conduct outreach and enrollment activities, the preparation and revision of handbooks that explain Title XIX and PeachCare for Kids programs, and the coordination of outreach activities with other local, state and federal agencies. ($340,000)
Assessing Consumer Satisfaction in Georgia's Medicaid Program. Jennifer Edwards. The Division of Medical Assistance is interested in learning more about the quality of care in the Medicaid program and beneficiary access to services. The Health Policy Center has conducted a survey of Medicaid beneficiaries and is in the process of analyzing the results. The results and recommendations will be presented to DMA in early 2000. ($350,000)
Evaluating Georgia's Children's Health Insurance Program (CHIP). Jennifer Edwards. The Health Policy Center is evaluating Georgia's new health insurance program to serve low-income children, PeachCare for Kids. The evaluation assesses the program's effectiveness in achieving several goals: improved access to insurance, improved access to primary care, access to high quality health services, and better health outcomes. The evaluation includes original data collection through surveys of new enrollees and applicants; evaluation of health insurance claims data; and a process evaluation of the implementation of the program. Results will support policy and program development at DMA, and will also be reported to the Health Care Financing Administration to be combined with results of other state CHIP programs. ($136,000)
Conducting Medicaid Reimbursement Studies. Susan R. Snyder. The Health Policy Center was awarded a contract by the Georgia Division of Medical Assistance to perform three reimbursement studies concerning financing related to the Medicaid population. The nursing home reimbursement study evaluated a proposed case-mix reimbursement method. An internal reimbursement study analyzed Georgia Medicaid's current approach to provider/service reimbursement for certain service areas, and identified issues and strategies to assist the Division in redesigning its reimbursement policies. The external access and reimbursement study assessed health care access standards and evaluated Georgia Medicaid's reimbursement levels for certain services, including comparisons with private and other public payers in Georgia and benchmark states. ($400,000)
General Projects
Grant from the Agency for Health Care Policy and Research (AHCPR) and the Packard Foundation. Jennifer Edwards. The Health Policy Center, in collaboration with faculty from Emory University and the University of Alabama at Birmingham were awarded a multi-year grant to study children's health insurance. The three-year study will examine the effect of the federal Children's Health Insurance Program (CHIP) and changes and expansions in Medicaid in Alabama and Georgia on access to care. The study will focus on provider availability and low-income children's subsequent access to, utilization of, and satisfaction with health services. Two sub-studies, one of African-American children and one of children with special health care needs, will be undertaken. ($90,000)
Publications
Access to Primary Care in Rural Georgia: A Population-Based Approach, Karen J. Minyard (with Susan B. Toal). Case Study, October, 1999.
Georgia Medicaid External Access and Reimbursement Study, Georgia Health Policy Center, December 1999.
Georgia Medicaid Internal Reimbursement Study Final Report, Georgia Health Policy Center, May 1999.
Georgia Medicaid Nursing Home Case Mix Project Final Report, prepared for the Georgia Health Policy Center by Greg Arling, University of Missouri at Kansas City, James Robinson, University of Wisconsin-Madison, and Kathy Wade, Myers and Stauffer, LC, December 1999.
Issues in Nursing Home Case Mix Reimbursement, prepared for the Georgia Health Policy Center by Greg Arling, University of Missouri at Kansas City, September 1999.
Newsletters prepared by the Georgia Health Policy Center:
Networks for Rural Health, January 1999
Collaborative Communique, May and September 1999
Conference Report Improving the Health of Georgia's Citizens A Report from a Conference to Explore Collaborative Opportunities for Government and the Philanthropic Community, November 1999
Georgia Health Policy Center Report, December 1999
Nursing Home Access and Reimbursement: National and Regional Perspectives on Issues Facing Georgia, prepared for the Georgia Health Policy Center by Greg Arling and David Sprick, University of Missouri at Kansas City, May 1999.
The Health Care System for Medicaid Children with Special Health Care Needs, S. Nicole Fehrenbach,* Jennifer N. Edwards, and Maria McHugh, Georgia Health Policy Center, December 1999.
Access to Primary Care in Rural Georgia: A Population-Based Approach, Karen J. Minyard (with Susan B. Toal). Case Study, October, 1999.
1. For a complete listing of AYSPS Active Research Sponsored Grants from CY1999, see the Appendix: Report on External Funding, which can be found at the end of this annual report.
