Sustainability Plan
The GREAT Health Program aims to increase resources, optimize services, and expand the healthcare workforce to improve health outcomes and access to care. By leveraging technology and policy solutions, the program will close the rural-urban divide, improve health outcomes, and advance Georgia’s transition towards value-based care.
Strategy to ensure lasting change
There are four key sustainability factors woven into the GREAT Health Program to include:
self-sustained infrastructure,
integrated telehealth services,
a shift to value-based care/AHEAD model, and
financial diversification.
Self-Sustaining Infrastructure- IT and Workforce Development
The Leveraging Technology for Healthcare Innovations initiative of the GREAT Health Program focuses on strengthening IT infrastructure and workforce systems to create a foundation that can sustain itself over time. The state is investing in these improvements to ensure that rural hospitals and clinics have the IT infrastructure required to advance value-based care and meet quality metrics. Once these improvements are complete, the technology will be self-sustaining, supported by commitments from funded organizations to cover future costs associated with maintenance, upgrades, and depreciation expenses. These upgraded systems are expected to generate increased revenue, cost-savings, and decreased readmissions and emergency department utilization, all of which will contribute to sustaining improved systems.
Workforce-focused efforts in the GREAT Health Program will similarly build self-sustaining models by creating an influx of providers into rural communities through incentives, scholarships, and expansion of faculty. Sustainability will be achieved through public-private partnerships that continue to support training and residency programs beyond the initial funding period. Healthcare facilities benefitting from recruitment and retention efforts will increase revenue from billable services and adopt employer-sponsored tuition models that “grow their own” workforce, ensuring a pipeline of trained providers in rural Georgia. These strategies, combined with early exposure to healthcare careers and rural settings for healthcare students, provide avenues to remedy immediate provider shortages and prepare for future needs.
Integrated Telehealth Services
The GREAT Health Program has embedded telehealth components as part of the Connecting to Care to Improve Healthcare Access, Growing a Highly Skilled Healthcare Workforce, and Leveraging Technology for Healthcare Innovation initiatives. The state realizes the critical role of telehealth in expanding access to care and providing essential provider training, particularly across a landmass as vast as Georgia. The state will ensure telehealth is integrated into future AHEAD payment models with Medicaid, Medicare, and private payers. Facilities receiving infrastructure resources for telehealth equipment will have realized billing revenue to assist with sustaining the equipment, staffing, and any future associated expenses. Georgia will monitor and support policies that apply to telehealth reimbursement for program improvement.
A Shift to Value-Based Care – AHEAD
Georgia will implement a value-based care model that incorporates populations covered by Medicaid, Medicare and commercial payers through the AHEAD model, transforming the way that rural care is provided and paid for in the state. By participating in the GREAT Health Program initiatives and strategies, rural hospitals, providers, and payers will build the necessary technology, infrastructure, and clinical shifts to pursue full participation in the AHEAD model. In three years, Georgia will assess hospital readiness, encourage participation, and review risk in early adoption with the goal of having facilities qualify for enrollment in the AHEAD program and increasing revenue from value-based metrics and global payments.
Funding Diversification to Sustain Programs and Services
Funding diversification is one of the factors associated with sustainability. Several funding diversification strategies were mentioned in the initiatives section of the proposal. These strategies include efforts such as charging user fees, soliciting private donations, seeking reimbursement for billable services once pathways are established, negotiating global payments, and creating other value-based reimbursement mechanisms. Additionally, the state and organizations benefiting from RHT Program funding can also pursue public-private partnerships, niche revenue generation (e.g., fees for consulting services), and absorption of programs by collaborative partners or organizations. The state will also focus on leveraging additional fiscal support for AHEAD implementation.
Integrate Lessons Learned into Ongoing Policy
Georgia’s current policy allows limited state funds to support GME, which is statutorily assigned to the GBHCW in O.C.G.A. 31-34. Results and learning from the workforce initiatives will illuminate opportunities in the following policy arenas: streamlining program approvals and reducing administrative barriers for training programs, updating training requirements to align with technology-enabled care delivery, and pursuing legislative authority to expand funding mechanisms to address the current program caps. Lessons learned from provider recruitment and retention over the five-year program will inform enhancements to the state’s provider recruitment plans moving forward. The state will also monitor and disseminate lessons learned around shifting to value-based care and global payments to inform future policy alignment that influences care delivery for improved health outcomes. Through the implementation of the AHEAD model, state Medicaid and employee health benefit policies will be adjusted to allow value-based purchasing and better incentivize whole-person health. Policy changes for other strategies in this proposal are not envisioned as Georgia law is already consistent with their activities. However, should the need for other policy changes arise, they will be pursued to the extent necessary to ensure program success.