Peach state vs caresource

View all of our health insurance plans available below. Select the program you are enrolled with. This will take you to more information about that program. If you do not know what program you are enrolled in, contact us. We can help! Take care of your family with full healthcare coverage, programs, and services from Peach State Health Plan. See all benefits PDF. A health insurance program for low-income families, pregnant women and women with breast or cervical cancer.

Georgia Medicaid members qualify for a free phone and plan via the federal Lifeline program. Members can apply for this free benefit. A Family planning program for women who do not qualify for Medicaid, or who have lost Medicaid coverage. The Health Insurance Marketplace is an online shopping mall of healthcare plans.

Peach State Health Plan's plan is called Ambetter. Ambetter offers affordable health care coverage for individuals and families. Depending on your family size and income, you may even qualify for help to pay your monthly premium. People age 65 and older, under 65 with certain disabilities, and any age with End-State Renal Disease — ESRD permanent kidney failure requiring dialysis or a kidney transplant may be eligible for coverage through Peach State Health Plan Advantage.

CareSource went live July 1, , servicing , Medicaid recipients. Some measures have as much as a two-year window for data to be captured, some of which would precede our [launch].

Additionally, we use the same providers that the other CMOs utilize. Georgia Health News compared the latest data from with the baseline data from In many cases the state did not meet its goal, and in many other cases performance stagnated. Jesse Weathington, executive director of the Georgia Quality Healthcare Association, an industry trade group, declined to comment on the performance measures.

Georgia faces a well-known maternal and infant health crisis, racial disparities in maternal and infant outcomes, and a shortage of specialist health care providers in rural areas of the state. Rates of timely prenatal care fell for two of the three CMOs that have been in Georgia since Back in , the state said its goal was to decrease the Medicaid low-birth-weight delivery rate to 8. But rates of these baby deliveries actually increased between and Postpartum care rates also dropped.

Low-birth-weight deliveries are those where the infant weighs less than five pounds, eight ounces. CareSource had the highest rate, with 9. Back in , the state centered its plan to reduce health disparities on lowering the disproportionately high rates of low-birth-weight deliveries among African Americans.

DCH does not break its data down by race, so there is no way to tell how well CMOs are addressing the racial disparity. As of , DCH stopped publishing data on two maternal health measures: frequency of prenatal care, and mental health screening for pregnant women. Maternal depression and substance abuse during pregnancy can have negative effects on both infant and postpartum maternal health. Early intervention can help head off these problems.

Babies should see a health care provider for a well-child visit at least six times between birth and 15 months, says the American Academy of Pediatrics. But according to the latest state data, only about two-thirds of Amerigroup, Peach State, and WellCare patients met this target.

The rates hovered around rates, showing little to no improvement. The Academy of Pediatrics also recommends that children between ages 3 and 6 see a doctor at least once a year. Checkup rates for improved slightly over for this age group. Amerigroup and Peach State improved by about 1 percentage point. Almost all childhood immunization rates dropped. Only one immunization rate — that of adolescents receiving vaccines for both meningitis and Tdap tetanus, diphtheria, and pertussis — increased.

Tracy Barr, a pediatrician in Kennesaw. Barr, the pediatrician, also noted that many parents in her office increasingly get anti-vaccine information from social media. Her office will treat children whose parents agree to a delayed schedule for vaccinations, but not those whose parents reject vaccination altogether. Such parents are asked to find another practice because of the risk that unvaccinated children pose to other patients.

Developmental screening looks for signs of developmental, social or behavioral problems such as speech issues, problems with motor skills, and even social delays. More than one-third of children on Medicaid and PeachCare are not receiving early childhood developmental screening. In good news, the CMOs all made big gains in childhood asthma treatment. For example, Amerigroup increased its rates for prescribing the recommended asthma drug combination by 13 percentage points among children and teenagers.

People with asthma need a drug to ward off asthma attacks and a separate drug to treat attacks, not just one drug or the other. CareSource data is not available for this measure. Childhood asthma is a leading cause of school absences among children, which in turn is a predictor of poor educational outcomes. Insufficient treatment of asthma can lead to chronic lung damage, along with increased hospitalizations and resulting increases in medical costs.

Insufficient treatment of asthma can lead to chronic lung damage, along with increased hospitalizations and resulting increases in medical costs, Barr pointed out. The CMOs improved their rates of annual adolescent checkups. Rates for screening and developing follow-up plans for depression among teenagers improved dramatically across the board. Still, though, the numbers indicate that just a small fraction of teenagers on Medicaid are being screened for depression.

Data for this age group is not available for prior years.

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The rates hovered around rates, showing little to no improvement. The Academy of Pediatrics also recommends that children between ages 3 and 6 see a doctor at least once a year. Checkup rates for improved slightly over for this age group. Amerigroup and Peach State improved by about 1 percentage point. Almost all childhood immunization rates dropped. Only one immunization rate — that of adolescents receiving vaccines for both meningitis and Tdap tetanus, diphtheria, and pertussis — increased.

Tracy Barr, a pediatrician in Kennesaw. Barr, the pediatrician, also noted that many parents in her office increasingly get anti-vaccine information from social media. Her office will treat children whose parents agree to a delayed schedule for vaccinations, but not those whose parents reject vaccination altogether.

Such parents are asked to find another practice because of the risk that unvaccinated children pose to other patients. Developmental screening looks for signs of developmental, social or behavioral problems such as speech issues, problems with motor skills, and even social delays. More than one-third of children on Medicaid and PeachCare are not receiving early childhood developmental screening.

In good news, the CMOs all made big gains in childhood asthma treatment. For example, Amerigroup increased its rates for prescribing the recommended asthma drug combination by 13 percentage points among children and teenagers. People with asthma need a drug to ward off asthma attacks and a separate drug to treat attacks, not just one drug or the other. CareSource data is not available for this measure. Childhood asthma is a leading cause of school absences among children, which in turn is a predictor of poor educational outcomes.

Insufficient treatment of asthma can lead to chronic lung damage, along with increased hospitalizations and resulting increases in medical costs. Insufficient treatment of asthma can lead to chronic lung damage, along with increased hospitalizations and resulting increases in medical costs, Barr pointed out. The CMOs improved their rates of annual adolescent checkups. Rates for screening and developing follow-up plans for depression among teenagers improved dramatically across the board.

Still, though, the numbers indicate that just a small fraction of teenagers on Medicaid are being screened for depression. Data for this age group is not available for prior years. Barr said that she sometimes has trouble getting specialist mental health care for her Medicaid patients.

Both pediatrician Barr and nurse practitioner Lockett put better transportation and care management on their wish lists for Georgia Medicaid. Medicaid does provide transportation, but it must be scheduled three days in advance, she said. Rebecca Grapevine is a freelance journalist who was born and raised in Georgia. She has written about public health in both India and the United States, and she holds a doctorate in history from the University of Michigan.

Hundreds of thousands of Georgians are at risk of losing Medicaid coverage as the federal public health emergency winds down. GPB is committed to bringing you comprehensive news coverage from Georgia, across the country and around the world. Your support makes this possible. Please consider making a gift today to support this vital public service. Banner Image. Section Branding. Primary Content. Secondary Content About the author. Rebecca Grapevine.

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