Government direct payment programs renewed for the 2023 government fiscal year

Georgia’s PDPP and HDPP will continue to provide increased Medicaid funding to eligible physicians and public hospitals.

The Georgia Department of Community Health (DCH) announced the renewal of two federally directed payment programs, the Physician Directed Payment Program (PDPP) and the Hospital Directed Payment Program (HDPP) for public hospitals. SFY23 is the third program year for PDPP and the second for HDPP.

Both programs are related to DCH’s goal to spend smarter through lower hospitalization and ED utilization rates. These efforts are specifically aligned with DCH’s quality strategy and are reviewed and evaluated annually.

“Our goal is to improve both access and quality while working to address health disparities related to chronic disease, preventive care, and women’s and child health for underserved populations,” said DCH Commissioner Caylee Noggle. “The renewal of these programs is part of our overall strategy to leverage direct payment programs to improve access to care and support payment rates for our providers and partners.”

Georgia’s PDPP provides state-directed payments to eligible physicians and other professional service providers affiliated with a state teaching hospital. In SFY23, eligible participants are expected to receive approximately $120.6 million in additional funding through rate increases to commercial equivalent.

Georgia’s HDPP provides additional Medicaid funding to eligible participating public hospitals. Public hospitals are defined as all government and non-government government hospitals, excluding critical access hospitals. In SFY23, eligible participants are expected to receive approximately $236.2 million in additional funding through rate increases up to the Medicare equivalent. This program aims to increase provider funding for critical services for the Medicaid population and strengthen Georgia’s health workforce.

State payment programs are submitted for annual approval by the Centers for Medicare and Medicaid Services. DCH has similar targeted payment programs pending with CMS aimed at benefiting teaching hospitals and private hospitals. If approved, the combined targeted payment programs would result in more than $800 million in new federal dollars in SFY23 flowing to hospitals across the state to improve access to care, health outcomes and equity, and the health workforce.

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