{"main_topic":"health","sub_topic":"oasis","topic":"births_by_payer","key":"health/oasis/births_by_payer","version":"1.0.0","year_min":2008,"year_max":2025,"year_gaps":[],"update_frequency":"annual","detail_levels":["counties","states"],"default_detail":"counties","path_template":"health/births_by_payer/year={year}/{detail}.parquet","grain":["year","county_fips","tract_geoid","payer"],"title":"Births by Payer (OASIS)","summary":"Each payer's share of live births to Georgia-resident mothers (Medicaid, private, self-pay, other, unknown; Medicare, PeachCare), Georgia and its counties, 2008-2025 (DPH OASIS).","description":"Payer mix of live births to Georgia-resident mothers: each payer's share of the births, by the payer recorded on the birth certificate (Medicaid, Medicare, private insurance, self-pay, PeachCare, all other payers, unknown), Georgia and each of its 159 counties, 2008-2025, from Georgia DPH's OASIS: the payer's share (key metric, our calculation), the payer's births and all births of the place and year. It starts in 2008: before then payer was recorded only as Medicaid or unknown (2000-2004), not at all (2005-2006) or partly (2007), so those years are not served; the births topic has the births of every year 2000-2025. Georgia 2025: private insurance 45.8%, Medicaid 39.8%, self-pay 8.2%, all other payers 6.0%; by county Medicaid runs from 9.7% (Chattahoochee) to 74.1% (Telfair) and private insurance from 6.0% (Atkinson) to 75.6% (Oconee), leaving out Early, Gordon and Toombs, whose 2025 shares reflect payer coding (limitations). Use it for who pays for births. For birth counts and rates, race and the mother's age use the births topic, whose num_births are this topic's num_births_all_payers: never add across the two.","explorer":true,"search_aliases":{"en":["who pays for births","medicaid births","medicaid babies","delivery payer","birth insurance type","self-pay births","uninsured births","private insurance births","peachcare","maternity coverage"],"es":["quién paga los partos","partos con medicaid","bebés de medicaid","seguro de maternidad","seguro privado","pago particular","peachcare","nacimientos sin seguro","asegurados y sin seguro","tipo de seguro"]},"source":"Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP), OASIS Data Table Tool, Births, by payor (Georgia birth certificates)","source_url":"https://oasis.state.ga.us/dtt/birth","endpoint":"/api/v1/health/births_by_payer","columns":[{"name":"year","type":"integer","role":"year","nullable":false,"label":"Year","short_description":"","description":"Calendar year of the birth, 2008-2025. Earlier years are not served: payer was recorded only in part before 2008 (limitations); the births topic has the births of every year 2000-2025.","valid_values":null,"example":2025,"unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"county_fips","type":"string","role":"fk_county","nullable":true,"label":"County FIPS","short_description":"","description":"5-digit FIPS of the mother's county of residence (FK to the counties dimension); NULL on Georgia's statewide row.","valid_values":null,"example":"13121","unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"tract_geoid","type":"string","role":"fk_tract","nullable":true,"label":"Tract GEOID","short_description":"","description":"Always NULL: state and county rows only.","valid_values":null,"example":null,"unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"payer","type":"string","role":"categorical","nullable":false,"label":"Payer","short_description":"Primary payer (Medicaid, Medicare, private, ...)","description":"The payer recorded on the birth certificate, probably the delivery's principal payer (our reading; limitations). OASIS: 'the primary entity responsible for payment of services'. Values: medicaid (Medicaid (Title XIX)); medicare (Medicare: people 65 and older, some disabled people under 65, and people with end-stage kidney disease); private_insurance (OASIS: Private Insurance, which includes Blue Cross/Blue Shield, HMO and other managed care, commercial insurance, PPO and POS plans and the State Health Benefit Plan); self_pay (OASIS: Self-Pay: no proof of insurance, patients filing their own claims or paying their own bills, Hill-Burton and charity cases); peachcare (PeachCare for Kids, Georgia's Children's Health Insurance Program, for children through 18 who do not qualify for Medicaid); other (OASIS: All other payors (all other plans)); unknown (OASIS: Unknown payors (no payer recorded)). The payers never overlap and add up to every birth (num_births_all_payers); there is no total row. medicare has rows only in 2013, 2014 and peachcare only in 2013, 2014, 2016 (no box on the certificate; limitations). Definitions: https://oasis.state.ga.us/dtt/content/DefBirth.html.","valid_values":["medicaid","medicare","private_insurance","self_pay","peachcare","other","unknown"],"example":"medicaid","unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":true,"metric_component":null},{"name":"pct_of_births","type":"number","role":"metric","nullable":true,"label":"Share of Births","short_description":"The payer's share of the births (our calculation)","description":"The payer's share of all births of the place and year: num_births / num_births_all_payers, our calculation from OASIS's counts. Unknown payer is in the denominator, so the payers' shares add up to 1. Combine places or years within one payer as SUM(num_births) / SUM(num_births_all_payers), never an average of shares. Georgia 2025: private_insurance 0.4584, medicaid 0.3984, self_pay 0.0817, other 0.0602, unknown 0.0014.","valid_values":null,"example":null,"unit":"proportion","value_min":null,"value_max":null,"null_meaning":"NULL only where the place had no births in the year (a share of nothing is undefined; our rule, the counts stay 0). Every place had births in every year 2008-2025, so no share is NULL.","key_metric_grain_contributor":false,"metric_component":null},{"name":"num_births","type":"integer","role":"metric","nullable":false,"label":"Number Births","short_description":"","description":"Live births to mothers resident in the place whose payer is this payer; twins are two births. OASIS publishes every count, however small; never NULL. The payers add up to num_births_all_payers. Georgia 2025, medicaid: 49,852.","valid_values":null,"example":null,"unit":"count","value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":"numerator"},{"name":"num_births_all_payers","type":"integer","role":"metric","nullable":false,"label":"Number Births All Payers","short_description":"","description":"All births of the place and year, every payer and unknown payer included (OASIS's All Payors; the payers' num_births summed), repeated on each payer's row as the share's denominator; it equals the births topic's num_births. Never sum it across payers. Georgia 2025: 125,143.","valid_values":null,"example":null,"unit":"count","value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":"denominator"}],"key_metric":"pct_of_births","numeric_filter_columns":["pct_of_births","num_births","num_births_all_payers"],"usage":"Look up payer mix with pct_of_births: the payers for one place and year, or one payer over time (2008-2025; payer was recorded only in part before 2008). There is no payer total row: num_births_all_payers is every birth. Combine places or years within one payer by adding counts: SUM(num_births) / SUM(num_births_all_payers), never an average of shares. num_births adds up across the payers to num_births_all_payers, which repeats on every payer row, so never sum it across payers. medicare and peachcare have rows only in the years they were recorded. These are births, not mothers (twins are two births). The births topic counts the same births (its num_births equals this topic's num_births_all_payers), has the birth and fertility rates, race and the mother's age, and the births of every year 2000-2025: never add figures across the two. Read directly with DuckDB over Parquet.","limitations":"Our calculation from OASIS's counts: each payer's share of births to Georgia-resident mothers, by the birth certificate's payer (the delivery's, our reading). Births, not mothers. Unknown payer is in the denominator: the payers' shares add to 1. Starts in 2008: payer was recorded only in part before. Some county-years reflect payer coding. For rates, race, mother's age or births before 2008 use the births topic; never add the two. Live births to mothers who live in Georgia, placed by the mother's county of residence (not where the birth happened); OASIS counts births, not pregnancies, so twins are two births. OASIS defines the payer as 'the primary entity responsible for payment of services' and does not name the certificate item. The 2003 U.S. standard birth certificate records the principal source of payment for the delivery in four checkboxes (private insurance, Medicaid, self-pay, other; NCHS, https://www.cdc.gov/nchs/products/databriefs/db468.htm), so the payer here is probably the delivery's principal payer (our reading; Georgia's own form is not published). The standard form has no Medicare or PeachCare box: medicare has births only in 2013 (13) and 2014 (4) and peachcare only in 2013 (63), 2014 (33) and 2016 (615), 0 in every place in every other year, so they have rows only in those years (no value can exist in the others); births they paid for are probably counted under other payers (our reading). OASIS publishes payer counts from 2000, but they are not payer mix before 2008, so those years are not served (checked on every run): in 2000-2004 a birth's payer is either Medicaid (42.5%-52.0% of Georgia's births a year) or unknown, every other payer 0 in every place; in 2005-2006 every birth is unknown payer; in 2007 75.5% of Georgia's births are unknown payer (a county median of 70.5%), the year OASIS says Georgia introduced the 2003 revision of the birth certificate (mid-2007, https://oasis.state.ga.us/animatedchartingtool/help/knowndataissues/birth; the link to payer is our reading). The births topic has the births of every year 2000-2025. Unknown payer is 23.5% of Georgia's births in 2008, 1.8% in 2014 and under 1% from 2015 (0.11%-0.26% a year from 2016), so from 2008 to 2014 every other payer's share rises partly because fewer births lack a payer. From 2015 it is at most 6.0% of a county's births (Cherokee 2015). In 129 county-years (45 counties) a payer's share sits far from the county's usual level, which probably reflects how the payer was recorded, not the county's payer mix (our reading; a payer's share more than 25 points from the county's own median over 2008-2025, in a county-year with 100 or more births, or 25 or more for unknown payer). In 94 of them, all in 2008-2012, unknown payer is far above the county's usual level, up to every birth (Terrell 2010: all 144; Dougherty 2008: 97.9% of 1,601; in small counties too, such as Baker, Calhoun, Clay, Echols, Quitman, Randolph and Towns; Baker 2010: 32 of 34), which lowers every other payer's share there. 19 more, in 2009-2013, are swaps into all other payers (Sumter 2011: 72.0% of 414 births), and Early 2008 is a Medicaid jump (66.9% of 175 births, against a median of 40.8%). From 2020, in 15 county-years, all other payers fall under 10% as Medicaid or private insurance rises (Early, Gordon, Montgomery, Seminole and Toombs; Toombs 2023: 3.0% of 369 births, against a median of 34.1%), where the earlier or the later years may be the accurate ones (our reading). Those flagged in 2025 (Early, Gordon and Toombs) may not have ended. All of them: Baker 2008-2012; Banks 2008; Barrow 2008-2009; Calhoun 2008-2012; Catoosa 2011; Charlton 2011; Chattooga 2008; Cherokee 2008-2009; Clay 2008-2012; Clayton 2008; Coweta 2008-2010; Dade 2009, 2011; Dawson 2008-2009; Dougherty 2008-2012; Early 2008, 2010, 2020-2025; Echols 2009; Fayette 2008-2010; Floyd 2008; Forsyth 2008-2009; Fulton 2008; Gordon 2022-2023, 2025; Gwinnett 2008-2010; Habersham 2008, 2011-2012; Hall 2008-2009; Jackson 2008; Jasper 2009-2011; Lee 2008-2013; Lumpkin 2008-2009; Mitchell 2008-2012; Montgomery 2023-2024; Pickens 2008, 2013; Polk 2008-2010; Quitman 2008, 2010; Rabun 2008, 2011-2013; Randolph 2008-2012; Seminole 2024; Stephens 2011-2013; Sumter 2008-2013; Terrell 2008-2012; Toombs 2023-2025; Towns 2008; Walker 2009-2011; Washington 2009, 2012; White 2008-2009; Worth 2008-2012. Compare a county's shares across years with care. Statewide, Medicaid's share falls from 44.9% in 2023 to 39.8% in 2025 (56,148 to 49,852 births) and private insurance's rises from 42.1% to 45.8% (52,565 to 57,371), after Medicaid's pandemic continuous enrollment ended in 2023 (our reading). The payer is as recorded on each birth certificate, so recording changes show as jumps between payers. OASIS counts HMO and other managed care under private insurance and does not say where Medicaid managed-care plans fall (our caution). num_births_all_payers equals the births topic's totals (demographic = 'all', mother_age = 'all') for every place and year, checked on every run; there is no payer total row. A share would be NULL only where a place had no births in a year; every place had births in every year 2008-2025, so none is NULL. 2025, the newest year, was added to OASIS on 2026-04-30; OASIS marks no year provisional. Counties add up to Georgia. OASIS's payer birth 'rates' are not served: each divides a payer's births by the same females as the all row (the place's females 10-55; checked on every published rate), not by that payer's mothers. tract_geoid is always NULL.","null_semantics":{"suppressed_to_null":false,"zero_is_real":true},"available_years":[2008,2009,2010,2011,2012,2013,2014,2015,2016,2017,2018,2019,2020,2021,2022,2023,2024,2025],"schema_hash":"73cfc50c43bef88761953bfadde4e9e66b48b4aeca6d62ca7a177a545116f8bd","tags":["health","georgia department of public health, office of health indicators for planning","births_by_payer"],"granularity_description":"One row per year, county_fips, tract_geoid, payer (geography columns are NULL at higher aggregation levels).","example_queries":[{"description":"Payer mix of Georgia's births, latest year","query":"SELECT payer, pct_of_births, num_births, num_births_all_payers FROM births_by_payer WHERE year = 2025 AND county_fips IS NULL ORDER BY pct_of_births DESC"},{"description":"Medicaid's share of each county's births, latest year","query":"SELECT county_fips, pct_of_births, num_births, num_births_all_payers FROM births_by_payer WHERE year = 2025 AND county_fips IS NOT NULL AND payer = 'medicaid' ORDER BY pct_of_births DESC"},{"description":"Georgia's payer mix over time","query":"SELECT year, payer, pct_of_births FROM births_by_payer WHERE county_fips IS NULL ORDER BY year, payer"}],"foreign_keys":[{"column":"county_fips","target_object":"counties","target_columns":["county_fips"],"attribute_columns_added":["county_name"],"scope":"global"},{"column":"tract_geoid","target_object":"tracts","target_columns":["tract_geoid"],"attribute_columns_added":["tract_name"],"scope":"global"}],"filters":[{"param":"year","kind":"year_exact","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"year_min","kind":"year_range","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"year_max","kind":"year_range","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"detail","kind":"detail","type":"string","multi_value":false,"enum_enforced":true,"values":["counties","states"],"default":"counties"},{"param":"county_fips","kind":"foreign_key","column":"county_fips","type":"string","multi_value":true,"enum_enforced":false,"values":null},{"param":"tract_geoid","kind":"foreign_key","column":"tract_geoid","type":"string","multi_value":true,"enum_enforced":false,"values":null},{"param":"payer","kind":"categorical","column":"payer","type":"string","multi_value":true,"enum_enforced":true,"values":["medicaid","medicare","private_insurance","self_pay","peachcare","other","unknown"],"has_total":false,"total_value":null,"requires_single_value":false,"nullable":false,"null_filter_token":null}],"filter_hints":[],"non_additive":[{"column":"payer","reason":"num_births_all_payers is all births of the place and year, repeated on every payer's row, so summed across payers it counts the same births once per payer. num_births adds up across the payers to num_births_all_payers.","metrics":["num_births_all_payers"]}],"partitions":[{"column":"payer","share":"pct_of_births","reason":"The payers never overlap and together are all births of the place and year, unknown payer included: each payer's pct_of_births is its num_births over num_births_all_payers, so across the payers the shares add up to 1 and num_births adds up to num_births_all_payers."}],"value_implications":[],"year_meaning":null,"pooled_rates":[],"series_breaks":[],"year_window":null,"pooled_min_count":null,"values_endpoint":"/api/v1/health/births_by_payer/values"}