Medicaid and State Health Benefit Plan

OHSC reviews existing policies, pilot programs, rules, regulations, and contracts to help coordinate Georgia’s healthcare delivery system. These reviews are related to the State's Medicaid program, PeachCare for Kids, and the State Health Benefit Plan. 

Recommendations to the Department of Community Health on State Health Benefit Plan (SHBP) contracts:

• Full Recommendations Report  (PDF, 761.14 KB)

Recommendations to the Department of Community Health on Medicaid managed care contracts:

• Full Recommendations Report  (PDF, 755.18 KB)
• Executive Summary for Georgia Families Contract Recommendations Report  (PDF, 453.77 KB)
• Executive Summary for Georgia Families 360 Contract Recommendations Report  (PDF, 389.23 KB)
• Contract Crosswalk: Georgia Families 360 and Texas STAR Health Contracts  (PDF, 325.21 KB)

Recommendations for the Medicaid Delivery System for Children in State Custody including those with Complex Needs Ages 18-21:

• Summary and Recommendations Report  (PDF, 448.92 KB)
• Summary and Recommendations PowerPoint  (PDF, 487.44 KB)

Recommendations to the Department of Community Health on the implementation of the Georgia Skilled Nursing Facility (SNF) Quality Incentive Payment Program:

• Report 1: Assessment and Recommendations for Inclusion of Quality Measures  (PDF, 3.4 MB)
• Report 2: Recommendations for Bonus Payment Allocation Process, the Implementation of a Quality Incentive Program Formula, and an Analysis of the Existing Quality Incentive Payment Program  (PDF, 1020.97 KB)