Tag Archives: GA

Market Overview PDF

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Georgia Medicare Market Overview

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GA Medicaid Management Care Enrollment is Up 7.9%, May-20 Data

Medicaid managed care enrollment in Georgia increased by 7.9% in May 2020 compared to year-end 2019, after increasing 1.3% in 2019 and decreasing 1.4% in 2018. CareSource entered the market in July 2017, reducing incumbents’ market share in the state.

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GA SNP Membership at 221,792, Mar-20 Data

Georgia had a total of 221,792 SNP members as of March 2020.

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MLRs Average 83% at GA Medicaid MCOs, 2019 Data

Average medical loss ratio among four Medicaid managed care plans was 83.0% in 2019. Per member per month premiums averaged $256.97.
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GA Medicaid Fee for Service vs. Managed Care Penetration, 2014-19

Total Medicaid enrollment in Georgia was 1.8 million in 2019. About 76.8% of Medicaid beneficiaries were enrolled in a managed care plan. The remainder are in fee-for-service Medicaid. Total Medicaid expenditures in Georgia was $10.8 billion in 2019, with about 29.6% through managed care and the rest through fee-for-service.

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GA Medicaid Management Care Enrollment is Up 1.7%, Apr-20 Data

Medicaid managed care enrollment in Georgia increased by 1.7% in April 2020 compared to year-end 2019, after increasing 1.3% in 2019 and decreasing 1.4% in 2018. CareSource entered the market in July 2017, reducing incumbents’ market share in the state.

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GA Section 1135 Waiver Approval, Apr-20

Georgia Section 1135 Waiver Approval, April 1, 2020.

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GA Receives Approval for Section 1135 Waiver

WALB reported on April 2, 2020, that Georgia received federal approval for a section 1135 waiver, providing flexibility in combating COVID-19. The waiver, which applies to Medicaid and PeachCare for Kids providers and members, temporarily suspends Medicaid fee-for-service prior authorizations, enrolls providers from other state Medicaid programs, waives in-state licensure requirements, ceases re-validation of providers, and allows for the provision of care in alternative settings. Read More

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GA Medicaid Management Care Enrollment is Flat, Mar-20 Data

Medicaid managed care enrollment in Georgia increased by 0.3% in March 2020 compared to year-end 2019, after increasing 1.3% in 2019 and decreasing 1.4% in 2018. CareSource entered the market in July 2017, reducing incumbents’ market share in the state.

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