Georgia community health

What Georgia community health does

The Georgia Department of Community Health (DCH) is a state government agency, established in 1999 and headquartered at 2 Martin Luther King Jr. Drive SE in Atlanta, operating as one of Georgia's four health agencies. DCH administers Medicaid, PeachCare for Kids (the state's CHIP program), the State Health Benefit Plan (SHBP, covering 660,000+ state employees, teachers, school personnel, and retirees), the Healthcare Facility Regulation Division (HFRD, overseeing more than 15,000 licensed facilities), and the State Office of Rural Health (SORH). The agency's programs reach approximately one in four Georgians across a state population exceeding 10 million.

The agency's core technology infrastructure is the Georgia Medicaid Management Information System (GAMMIS), operated by Gainwell Technologies under a fiscal agent contract initiated in November 2010. GAMMIS integrates claims processing, provider enrollment, eligibility verification, benefit management, managed care enrollment, and prior authorizations for Medicaid and PeachCare for Kids. Supporting systems include GaMap2Care (a public-facing facility locator with inspection reports and complaint filing), the NCQA-certified Centralized Credentialing Verification Organization (CVO) that streamlines provider credentialing across contracted Care Management Organizations, and the Office of Analytics and Program Improvement, which provides analytic-ready data and interagency data sharing. Provider services are delivered through three contracted Care Management Organizations: Amerigroup, CareSource, and Peach State Health Plan. DCH also administers the Certificate of Need (CON) program to control healthcare costs and capital expenditures.

DCH is funded through a combination of Georgia state appropriations, federal Medicaid matching funds, provider fees and assessments deposited into the Indigent Care Trust Fund (ICTF), and intergovernmental transfers (IGTs) that fund State Directed Payment Programs totaling approximately $4.5 billion over four years. The agency has secured $409 million for a new 300-bed mental health hospital, $50 million for a University of Georgia Medical School, and $52 million+ for Graduate Medical Education initiatives, and has submitted a five-year $1.4 billion Rural Health Transformation Program plan covering 29 projects. The agency is governed by a nine-person Board of Community Health appointed by the Governor and led by Commissioner Dean Burke, MD, with approximately 1,001–5,000 employees across Atlanta and Cordele locations. As a government state entity, DCH is not equity-funded, does not have a public ticker, and is not subject to traditional PE/VC investment.

Name

Georgia community health

Legal name

Georgia Department of Community Health

Website

https://dch.georgia.gov

Company type

Private

Founded year

1999

Operating status

Operating

Headcount range

501–1,000 employees

Short description

The Georgia Department of Community Health (DCH) is a state agency administering Medicaid, PeachCare for Kids, the State Health Benefit Plan, and healthcare facility regulation, serving over 10 million Georgians through programs that reach one in four state residents.

Ownership category

akta.pro rank

Product category

Government Healthcare Administration

NAICS

Administration of Public Health Programs (92312)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

State/Provincial Health Department & Public Health Administration (BPAIABAH)

akta.pro secondary industry

State/Provincial/Regional Health Departments (HLAJAAAA)

Keywords

• Medicaid administration services
• State health benefit plans
• Healthcare facility regulation
• Children health insurance program
• Rural health programs

Headquarters

HQ city

Atlanta

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Infrastructure, Others

Revenue model

1. State Appropriations and Federal Medicaid Funds: DCH operates as a state government agency funded through Georgia state appropriations and federal Medicaid matching funds to administer Medicaid, PeachCare for Kids, and State Health Benefit Plan programs
2. Provider Fees and Assessments: Hospital provider fees, nursing home provider fees, ambulance licensing fees, and Certificate of Need penalties deposited into the Indigent Care Trust Fund to match federal Medicaid dollars
3. Intergovernmental Transfers (IGT): State Directed Payment Programs funded through IGTs from hospital authorities and governmental entities to direct payments to healthcare providers

Distribution channels4 records

Marketing channels6 records

Core offering

The Georgia Department of Community Health (DCH) is a state government agency that administers Georgia's Medicaid and PeachCare for Kids programs, oversees the State Health Benefit Plan covering more than 660,000 public employees and retirees, and regulates more than 15,000 healthcare facilities through the Healthcare Facility Regulation Division. The agency also operates the State Office of Rural Health, GAMMIS claims processing platform, GaMap2Care facility locator, and Centralized Credentialing Verification Organization.

Product overview

The Georgia Department of Community Health (DCH) is a state government agency operating a multi-product healthcare administration portfolio rather than a unified commercial product. The core programs include Medicaid (federal/state medical assistance for low-income individuals), PeachCare for Kids® (CHIP program for uninsured children), and the State Health Benefit Plan (SHBP, covering 660,000+ state employees and retirees). Regulatory divisions include the Healthcare Facility Regulation Division (HFRD, overseeing 15,000+ facilities) and the State Office of Rural Health (SORH). DCH administers numerous waiver and support programs including Home and Community Based Services (HCBS), Georgia Pathways to Coverage™, the Indigent Care Trust Fund, and State Directed Payment Programs (including GA-STRONG, GA-AID, and Hospital DPP). Technology infrastructure includes GAMMIS (claims processing), GaMap2Care® (facility finder), and a Centralized CVO for provider credentialing. All programs are governed by a nine-person Board appointed by the Governor, with the Commissioner leading approximately 1,000+ employees across Atlanta and Cordele locations.

Differentiator

Problem solved

Functional benefit

Brands

• PeachCare for Kids: A comprehensive healthcare program for uninsured children living in Georgia, part of the Children's Health Insurance Program (CHIP).
• Georgia Pathways to Coverage
• State Health Benefit Plan (SHBP)
• Georgia Families
• GaMap2Care

Products and services

• Medicaid

Quantifiable outcome

• Pathways to Coverage program enrolled approximately 8,077 individuals within two years of launch
• +2 more outcomes

Named customers4 records

Segments5 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Six partnerships are on record, tiered core.

• Gainwell Technologies (formerly Hewlett-Packard Enterprise Services)coreTechnology or Integration · 1 November 2010Gainwell Technologies serves as the fiscal agent for Georgia Medicaid and PeachCare for Kids, operating the GAMMIS portal for claims processing, provider enrollment, and member services since November 2010. The company provides technical infrastructure and support for Medicaid Management Information System operations.
• AmerigroupcoreChannel Partner/ Reseller/ DistributorCare Management Organization (CMO) contracted to deliver Medicaid managed care services; providers may contact Amerigroup at 678-587-4840 for contracting and provider relations
• CareSourcecoreChannel Partner/ Reseller/ DistributorCare Management Organization (CMO) contracted to deliver Medicaid managed care services; providers may contact CareSource at 1-855-202-1058 for contracting and provider relations
• Peach State Health PlancoreChannel Partner/ Reseller/ DistributorCare Management Organization (CMO) contracted to deliver Medicaid managed care services; providers may contact Peach State at 1-866-874-0633 for contracting and provider relations
• HI-BRIDGE Solutions (formerly GA-HITEC)coreTechnology or IntegrationTechnical assistance provider helping eligible professionals and hospitals meet meaningful use requirements for Electronic Health Records (EHR) under the Medicaid Promoting Interoperability Program
• Centers for Medicare & Medicaid Services (CMS)coreStrategic or Co-development PartnerFederal agency providing 100% funding for the Medicaid Promoting Interoperability Program and overseeing state Medicaid programs through federal-state partnership agreements

Scale indicators13 records

Recent moves6 records

Expansion highlights6 records

Others

• Conduent Incorporated: Provides Medicaid management, pharmacy benefits administration, and eligibility services to state agencies. Comparable as a state health services vendor and integrator that competes for fiscal-agent contracts analogous to Gainwell's GAMMIS role at DCH.
• MAXIMUS: Provider of Medicaid and CHIP fiscal agent, eligibility, and enrollment services for multiple states. Comparable ecosystem role to DCH's Gainwell partnership and competes for similar state Medicaid technology contracts; relevant as an alternative MMIS vendor and operational peer.
• Gainwell Technologies: Core technology vendor operating Georgia's GAMMIS portal as fiscal agent since November 2010. Functions as the systems integrator and infrastructure provider rather than a competitor, but is materially intertwined with DCH's Medicaid claims, enrollment, and prior authorization operations.
• Centers for Medicare & Medicaid Services (CMS): The federal counterpart that funds and oversees state Medicaid programs including Georgia's. DCH's relationship with CMS (e.g., 100% funding for the Medicaid Promoting Interoperability Program) makes CMS the primary upstream regulator and capital source, though it is not a competitive peer.

Direct peers

• CareSource: Non-profit managed care plan serving as a contracted CMO in Georgia Families alongside Amerigroup and Peach State. Comparable as a Medicaid managed care operator coordinating benefits for the same DCH-administered member population.
• Florida Agency for Health Care Administration: Florida's primary state agency for administering Medicaid, licensing healthcare facilities, and publishing health care data. Closely comparable to DCH in scope (Medicaid administration, facility regulation, managed care oversight) and population scale, making it the most directly comparable state peer.
• Amerigroup (Elevance Health): One of three Care Management Organizations contracted to deliver Georgia Families Medicaid managed care. Operates Medicaid plans in multiple states with comparable member services, provider networks, and value-based contracting models to those coordinated by DCH.

Broad incumbents

• New York State Department of Health: Administers New York's Medicaid program, regulates healthcare facilities, and runs public health programs for a population of similar order of magnitude to Georgia's. Comparable in regulatory authority scope, MMIS operations, and managed care contracting, but with broader public health remit.
• California Department of Health Care Services: California's Medicaid (Medi-Cal) administrator serving the largest Medicaid population in the US. Comparable in administering Medicaid benefits, managed care plans, HCBS waivers, and State Directed Payment Programs, though materially larger in scale and budget.
• Texas Health and Human Services Commission: Texas's combined health and human services agency administers Medicaid, CHIP, and regulates healthcare facilities for a population several times larger than Georgia's. Directly comparable as a state-level public health administrator with similar Medicaid/CHIP program structure, managed care delivery, and legislative appropriations model.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/gadch
• YouTubeyoutube.com/user/gacommunityhealth
• Facebookfacebook.com/info
• LinkedInlinkedin.com/company/georgia-department-of-community-health

Revenue estimate

Valuation estimate

Number of profiles

Profiles15 records

Subsidiaries8 records

Funding overview

Funding rounds1 record

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Georgia community health