Enrollment Distribution by Program 
Includes FFS expense and capitation amounts 
 
State Health Benefit Plan 
648,288 
(26%) 
PeachCare 
218,153 
(9%) 
 
Medicaid 
1,586,524 
(65%) 
 
Includes Medicare eligible members 
Expense Per Member Per Year 
 
$6,000.00 $5,000.00 
 
$5,075.46 
 
$4,000.00 
 
$3,000.00 $2,000.00 
 
$1,801.70 
 
$1,000.00 
 
$0.00 
 
Medicaid 
 
PeachCare 
 
Annual Scripts Per Member 
 
$4,679.72 
State Health Benefit Plan 
 
12 9.96 
10 
8 
6 
4 
2 
0 Medicaid 
 
6.23 PeachCare 
 
Annual Office Visits Per 1000 Members 
 
9.51 
State Health Benefit Plan 
 
5,600 5,400 5,200 5,000 4,800 4,600 4,400 4,200 
 
5,358.95 Medicaid 
 
5,280.61 4,710.89 
 
PeachCare 
 
State Health Benefit Plan 
 
Claims Incurred July 2012 - June 2013, paid through Sept 2013 
Expense Distribution by Program 
Includes FFS expense, capitation amounts and healthcare reimbursement amounts 
 
PeachCare 
$393,046,314 
(4%) 
 
State Health Benefit Plan 
$2,587,731,697 
(23%) 
 
Medicaid 
$8,052,335,601 
(73%) 
 
Expense Per Member Per Month 
 
$500.00 $400.00 
 
$422.95 
 
$300.00 
 
$200.00 $100.00 
 
$150.14 
 
$- 
 
Medicaid 
 
PeachCare 
 
Annual ER visits Per 1000 Members 
 
$389.98 
State Health Benefit Plan 
 
1200 1000 
800 600 400 200 
0 
 
1,075.57 Medicaid 
 
478.54 PeachCare 
 
Annual Admits Per 1000 Members 
 
1,003.40 
State Health Benefit Plan 
 
250 
 
222.03 
 
200 
 
150 
 
100 
 
50 
 
0 Medicaid 
 
197.19 
 
16.49 PeachCare 
 
State Health Benefit Plan