Case Study: Georgia Department of Community Health achieves national recognition for proactive Medicaid quality measurement with Truven Health Analytics

Proactive Quality Measurement Shows Impact of Managed Care Initiatives

The Georgia Department of Community Health (Georgia DCH), responsible for providing access to quality care for more than 1.6 million Medicaid managed care members, needed a more rigorous way to measure and track quality after implementing managed care in 2006. Although the state conducted annual HEDIS reviews, Georgia DCH wanted deeper, multi-year analyses and population health tracking to better evaluate access and outcomes across its Low Income Medicaid and PeachCare for Kids® programs.

Georgia DCH engaged Truven Health Analytics to derive more than 45 measures following strict HEDIS and AHRQ specifications, using NCQA‑certified Quality Spectrum Insight and Truven’s DataProbe across three years and multiple population strata. Results were validated by the state’s External Quality Review Organization, benchmarked nationally, submitted to CMS, and helped Georgia earn national recognition (the only state spotlighted in the 2011 HHS report), reporting 18 of 24 CHIPRA metrics for FFY2010 and using the measures to drive contracts, auto‑assignment, and quality improvement.

Georgia Department of Community Health

Jerry Dubberly

Georgia Medicaid Chief