Category Grades
31C- 29D+
Access to Emergency Care:
44F 46F
Quality/Patient Safety:
37D+ 26C
Medical Liability:
4A 12B-
Public Health/ Injury Prevention:
24C- 31D+
Disaster Preparedness:
22C+ 32D+

Georgia's strong Medical Liability Environment continues to be its biggest asset, although the state has made considerable progress in improving its Quality and Patient Safety Environment. Georgia continues, however, to suffer from health care workforce shortages and financial barriers to care, putting Access to Emergency Care in this state among the worst in the nation.

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Georgia continues to support a strong Medical Liability Environment with protections for health care providers. It prohibits apologies by providers from being used as evidence of wrongdoing and has enacted additional liability protections for care mandated by the Emergency Medical Treatment and Labor Act (EMTALA), which protects providers caring for very high-risk patients with little or no knowledge of their medical history. The state has numerous expert witness rules and is one of three states that require expert witnesses to be licensed to practice medicine in the state. Despite the positive overall environment, however, Georgia's medical liability cap on non-economic damages was ruled unconstitutional in 2010, and other challenges persist.

Georgia has demonstrated a strong commitment to improving the Quality and Patient Safety Environment by incorporating Centers for Disease Control and Prevention guidelines into its state field triage protocols. Georgia continues to fund a state emergency medical services (EMS) medical director and has destination policies in place that allow EMS to bypass local hospitals to take stroke, ST-elevation myocardial infarction, and trauma patients to a hospital specialty center.

While some work is still needed, Georgia has made improvements in Disaster Preparedness. The state's medical response plan now includes patients with special needs, mental health patients, and patients dependent on medications or dialysis. Georgia has also implemented a paper-based statewide patient tracking system and is in the process of implementing an electronic patient-tracking system for everyday use as well as disaster use. It has one of the top 10 bed surge capacities in the nation (1,507.0 beds per 1 million people). The state also has a high number of burn unit beds (9.4 beds per 1 million), although there is a noted shortage of intensive care unit beds (204.2 per 1 million).


Georgia's biggest challenge is ensuring that all people have adequate Access to Emergency Care. The state has low per capita rates of specialists, including emergency physicians; neurosurgeons; orthopedists and hand surgeons; plastic surgeons; ear, nose, and throat specialists; and registered nurses. Access to mental health care is a particular problem for Georgia, with only 17.9 psychiatric care beds for every 100,000 people and a need for additional mental health care providers. The state has a shortage of physicians accepting Medicare fee-for-service patients (2.7 per 100 beneficiaries). Georgia's population struggles with adequate insurance coverage: 22.2% of adults and 10.9% of children have no health insurance, and both groups have high proportions of people who are underinsured (9.1 and 18.5%, respectively).

Georgia has a mixed report card in Public Health and Injury Prevention. The state is second in the nation in early childhood immunizations (83.9%). At the same time, it has some of the lowest rates of influenza and pneumococcal vaccination among older adults (55.2 and 66.5%, respectively). Georgia has the third lowest rate of traffic fatalities that are alcohol-related (26%), but it also has very high rates of bicyclist fatalities (8.3 per 100,000 cyclists) and pedestrian fatalities (9.4 per 100,000 pedestrians).


Georgia's most pressing concern is attracting needed specialists and other health care providers to the state to improve Access to Emergency Care. In addition, improved health insurance coverage for adults and children in Georgia is necessary to ensure that they can afford care when needed.

Additionally, Georgia must address the racial and ethnic disparities that persist for cardiovascular disease, HIV diagnoses, and infant mortality. The state has the seventh highest cardiovascular disease disparity ratio, with Native Americans having rates of cardiovascular disease that are 2.8 times higher than the race with the lowest likelihood of developing heart disease. Similarly, non-Hispanic Black infants are 3.1 times more likely to die in the first year of life than the race that is least likely. Georgia should work to ensure that all of its citizens have adequate access to preventive health care, education, treatment, and support to reduce these disparities.

Although Georgia has many strong Disaster Preparedness policies, it is nearly last in the nation in terms of physicians, nurses, and behavioral health professionals registered in the Emergency System for Advance Registration of Volunteer Health Professionals. Engaging health care professionals in Disaster Preparedness is needed to support Georgia's ability to respond quickly and effectively during a disaster or mass casualty event.

Access to Emergency Care

Title 2009
Report Card
Report Card
Board-certified emergency physicians per 100,000 pop 7.0 8.0
Emergency physicians per 100,000 pop 9.7 10.4
Neurosurgeons per 100,000 pop 1.4 1.6
Orthopedists and hand surgeon specialists per 100,000 pop 7.1 7.5
Plastic surgeons per 100,000 pop 1.9 1.9
ENT specialists per 100,000 pop 3.1 3.2
Registered nurses per 100,000 pop 666.1 664.9
Percent of children able to see provider 95.9
Level I or II trauma centers per 1M pop 1.2 1.1
Percent of population within 60 minutes of Level I or II trauma center 83.8 89.6
Accredited chest pain centers per 1M pop 1.0 2.6
Percent of population with an unmet need for substance abuse treatment 6.4 7.5
Pediatric specialty centers per 1M pop 2.9 2.6
Medicaid fee levels for office visits as a percent of the national average 109.0 137.1
Percent change in Medicaid fees for office visits (2004-05 to 2007/2007 to 2012) 0 54.5
Percent of adults with no health insurance 19.5 22.2
Percent of adults underinsured 9.1
Percent of children with no health insurance 12.8 10.9
Percent of children underinsured 18.5
Percent of adults with Medicaid 6.4 7.4
Hospital closures in 2006/2011 1 0
Staffed inpatient beds per 100,000 pop 331.1 304.9
Hospital occupancy rate per 100 staffed beds 70.9 67.7
Psychiatric care beds per 100,000 pop 22.9 17.9
Median time from ED arrival to ED departure for admitted ED patients 279
State collects data on diversion YES NO

Disaster Preparedness

Title 2009
Report Card
Report Card
Per capita federal disaster preparedness funds $8.33 $4.72
State budget line item health care surge NO
ESF-8 plan is shared with all EMS and essential hospital personnel YES YES
Emergency physician input into the state planning process YES, YES YES
Public health and emergency physician input during an ESF-8 response YES
Drills, exercises conducted involving hospital personnel, equipment, or facilities per hospital
Accredited by the Emergency Management Accreditation Program (EMAP) YES, ACCREDITED YES
Special needs patients included in medical response plan NO YES
Patients dependent on medication for chronic conditions in medical response plan NO YES
Medical response plan for supplying dialysis NO YES
Mental health patients included in medical response plan YES
Medical response plan for supplying psychotropic medications YES
Mutual aid agreements in place with behavioral health providers STATE LEVEL
State requires long-term care and nursing home facilities to have a written disaster plan YES
State able to report number of exercises involving long-term care facilities or nursing NO
Just-in-time training systems in place STATEWIDE STATEWIDE
Statewide medical communication system with one layer of redundancy YES YES
Statewide patient tracking system NO YES
Statewide real-time or near real-time syndromic surveillance system YES YES
Real-time surveillance system in place for common ED presentations YES YES, IN METROPOLITAN AREAS
Bed surge capacity per 1M pop 1,400.1 1,507.5
ICU beds per 1M pop 252.6 204.2
Burn unit beds per 1M pop 8.6 9.4
Verified burn centers per 1M pop 0.0 0.2
Physicians registered in ESAR-VHP per 1M pop 2.7 2.5
Nurses registered in ESAR-VHP per 1M pop 23.6 56.8
Behavioral health professionals registered in ESAR-VHP per 1M pop 2.6
Strike teams or medical assistance teams YES YES
Disaster training required for essential hospital/EMS personnel NO, NO NO
Percent of RNs that received emergency training 43.9 37.3

Medical Liability Environment

Title 2009
Report Card
Report Card
Lawyers per 10,000 pop 15.1 14.7
Lawyers per physician 0.7 0.6
Lawyers per emergency physician 15.3 14.1
ATRA judicial hellholes (2009 range 0 to -7/2014 range 2 to -6) -1 0
Malpractice award payments per 100,000 pop 0.9 1.7
Average malpractice award payments $309,492 $358,985
National Practitioner Databank reports per 1,000 physicians 18.1 20.2
Apology laws: Apology is inadmissible as evidence in a court of law YES
State has implemented a patient compensation fund NO NO
Number of insurers writing medical liability policies per 1,000 physicians 4.0 4.4
Average medical liability insurance premiums for primary care physicians $15,113 $14,572
Average medical liability insurance premiums for specialists $63,174 $58,811
Presence of pretrial screening panels NONE NO
Pretrial screening panel's findings admissible as evidence N/A N/A
Periodic payments are: required, granted upon request, at court's discretion UPON REQUEST OR AGREEMENT OF PARTY(IES) UPON REQUEST
Medical liability cap on non-economic damages $250,001-350,000 NONE
Additional liability protection for EMTALA-mandated emergency care YES YES
Joint and several liability abolished YES YES
Collateral Source Rule/Provides for Awards to be Offset NO
State provides for case certification YES YES
Expert witness required to be of the same specialty as the defendant YES YES
Expert witness must be licensed to practice medicine in the state YES YES

Public Health & Injury Prevention

Title 2009
Report Card
Report Card
Bicyclist fatalities per 100,000 cyclists 8.3
Pedestrian fatalities per 100,000 pedestrians 9.4
Percent of traffic fatalities alcohol-related 36.0 26.0
Percent of front occupants using restraints 89.0 93.0
Child safety seat/seat belt legislation - score out of a possible 10 points 5 7
Helmet use required for all motorcylce riders YES YES
Distracted driving legislation score - out of a possible 4 points 2
Graduated drivers' licenses legislation score -out of a possible 5 points 0
Percentage of children aged 19-35 months who are immunized 83.3 83.9
Percentage of adults aged 65+ who rec’d an influenza vaccine in the last 12 mos 64.8 55.2
Percentage of adults aged 65+ who ever rec’d pneumococcal vaccine 63.1 66.5
Fatal occupational injuries per 1M workers 45.1 23.2
Homicides and suicides (non-motor vehicle)(per 100,000) 17.2 18.2
Unintentional fall-related fatal injuries (per 100,000) 6.0 6.4
Fire/burn related fatal injuries (per 100,000) 1.5 1.1
Rate of unintentional firearm-related fatal injuries (per 100,000) 0.3 0.3
Rate of unintentional poisoning-related deaths (per 100,000) 10.1
Total injury prevention funds per 1,000 persons $170.77 $320.98
Dedicated child injury prevention funding YES
Dedicate elderly injury prevention funding NO
Dedicated occupational injury prevention funding YES
Anti-smoking legislation score - score out of a possible 3 points 0
Infant mortality rate per 1,000 live births 8.2 6.4
Percentage of adults who binge drink 12.1 16.6
Percentage of adults who currently smoke 19.9 21.2
Percentage of adult population who are obese (BMI > 30.0) 27.1 28.0
Percentage of children who are obese 16.5
Cardiovascular disease disparity ratio 2.8
HIV diagnosis disparity ratio 16.2
Infant mortality disparity ratio 3.1

Quality & Patient Safety

Title 2009
Report Card
Report Card
Funding for quality improvement within the EMS system NO NO
Funded state EMS medical director YES YES
Emergency medicine residents per 1M pop 8.8 9.4
Adverse event reporting required YES YES
% of counties with Enhanced 911 capability 91.2 97.5
State has a uniform system for providing pre-arrival instructions NO NO
State uses CDC guidelines for state field triage protocols YES (2011)
State has or is working on a stroke system of care YES YES
State has triage and destination policy in place for stroke patients YES
State has or is working on a PCI network or a STEMI system of care NR YES
State has triage and destination policy in place for STEMI patients YES
State maintains statewide trauma registry YES YES
State has triage and destination policy in place for trauma patients YES
Prescription drug monitoring program score (range 0-4) 2
% of hospitals with computerized practitioner order entry 20.8 71.7
% of hospitals with electronic medical records 47.6 95.0
% of patients with AMI given PCI within 90 minutes of arrival 53 93
Median time to transfer to another facility for acute coronary intervention 58
% of patients with AMI who received aspirin within 24 hours 99
% of hospitals collecting data on race/ethnicity and primary language 50.3
% of hospitals with or planning to develop a diversity strategy or plan 43.7

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