A House Republican’s plan to fix Georgia’s rural hospital crisis

A House Republican will introduce a measure this week that would create as many as 100 new healthcare centers geared to low-income residents in some of the state’s poorest areas.

State Rep. Geoff Duncan, a Cumming health executive with an eye on higher office, said his measure would amount to a “tectonic shift” in Georgia’s healthcare policy that was partly prompted by the collapse of rural hospitals. At least eight have shuttered since 2001 and more than a dozen others are on the verge of failing.

“We have to be willing to look outside the box,” said Duncan. “That’s what corporate America is doing with this debate, and that’s what our citizens hope we can do.”



Duncan was behind a plan last year that offered tax credits for donors to rural hospitals – it was dubbed a “lifeline” for struggling medical centers – but donors have so far applied for only a small fraction of the credits.

He pitched this as a more sweeping idea to bolster Georgia’s healthcare safety net without expanding Medicaid under the Affordable Care Act, which Democrats have long said would help save struggling hospitals but Republicans deride as too costly in the long run.

The first part of Duncan’s plan would move Georgia’s State Health Benefit Plan, which manages billions of dollars in state insurance policies, from the Department of Community Health the the Department of Administrative Services – and require the agency to hire a chief data officer skilled in predictive modeling and other tools of the trade to run the program.

The second part seems likely to grab more attention.  That department would be authorized to create as many as 100 federally qualified health centers – nonprofit centers that provide healthcare to low-income patients regardless of insurance coverage or ability to pay – and then give families covered by the state health insurance plan incentives to use the centers.

Each new center – there are already about 200 in Georgia – would be required to handle mental illnesses and opioid addictions, and the department would be encouraged to create a co-op for all the centers to buy their medical equipment and other supplies in bulk.

Duncan doesn’t have the backing of the governor or other top GOP leaders yet, nor does he have a fiscal note. But he estimates the measure could cost as much as $25 million if all 100 centers are opened. He said cost-savings in the long run from consolidating  expenses, cheaper pharmaceutical costs and leveraging federal aid would be worth the short-term funding.

“It’s a new way of thinking, and I’m assuming there’s going to be obstacles and barriers,” said Duncan. “But right off the bat, this could have huge savings.”

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