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State officials with the N.C. Department of Health and Human Services presented their Medicaid reform plan to the General Assembly on Monday. Here is the agency’s press release on the plan. The full proposal may be read below.

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Aldona Wos. Photo via Gov. Pat McCrory’s office.

“We have an obligation – an obligation we have willingly accepted as a state – to help those in need. And we must, at the same time, be good stewards of taxpayer resources,” said DHHS Secretary Aldona Wos, in a press release. “We believe this Medicaid reform plan is responsive to both those obligations.”

The plan proposes that providers collaborate through accountable care organizations, a model that allows physicians and other providers who care for patients to take control of improving quality and healthy outcomes.

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“When ACOs share in the savings or losses based on quality measures, everyone has a vested interest in making Medicaid a success,” Wos said. “We expect the ACO model to bend the cost curve by approximately 2-3 percent, which would mean hundreds of millions of dollars in savings for the state.”

The reform plan is based on input received during nearly 15 months of discussions with stakeholders throughout the state, including beneficiaries, caregivers, providers, health care organizations and the work of the Medicaid Reform Advisory Group.

“The reform proposal being submitted today to the General Assembly is a good and thoughtful plan,” said Dennis Barry, advisory group chair and CEO emeritus of Cone Health. “Importantly, it builds on the existing strengths of the current care systems operating in North Carolina.”

DHHS is taking a dual approach to Medicaid reform as efforts also are under way to improve the Division of Medical Assistance (DMA) operations to support Medicaid reform.

Wos recently named Deputy Secretary of Health Services and Acting State Health Director Robin Gary Cummings, M.D., to lead the DMA transformation. He is overseeing efforts to improve existing operating processes to increase forecasting accuracy and deliver Medicaid services more efficiently and effectively.

Since its inception in 1970, the N.C. Medicaid program has evolved into an essential component of the state’s health care system. It currently serves about 1.8 million low-income parents, children, seniors and people with disabilities and requires $13.5 billion a year to operate.

Medicaid Advisory Group members include Dennis Barry of Greensboro, chair, CEO emeritus of Cone Health; Peggy Terhune, Ph.D., of Randolph County, executive director and CEO of Monarch; Richard Gilbert, M.D., of Mecklenburg County, former chief of staff for Carolinas Medical Center; state Rep. Nelson Dollar of Wake County and state Sen. Louis Pate, who represents Lenoir, Pitt and Wayne counties.

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DHHS Medicaid Reform Legislative Report 2014 03 17 (PDF)
DHHS Medicaid Reform Legislative Report 2014 03 17 (Text)

Angie Newsome

Angie Newsome is the executive director and editor of Carolina Public Press. Contact her at (828) 774-5290 or e-mail her at anewsome@carolinapublicpress.org.

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  1. House Speaker Thom Tillis, R-Mecklenburg, said in a release that legislators and McCrory’s administration “all share the same goals for Medicaid: to improve access, lower costs, and improve health care outcomes in North Carolina. I’m confident we will achieve all three where others have failed to do so.”

    NC CAN NOT ACHIEVE THE GOALS OUTLINED WITHOUT EXPANDING MEDICAID FOR THE HUNDREDS OF THOUSANDS THAT MCCRORY, TILLIS AND POPE HAVE REF– USED TO DO.

    WHILE OTHER REPUBLICAN CONTROLLED STATES IOWA, UTAH, ARKANSAS, PENNSYLVANIA, VERMONT, AND WISCONSIN ARE GETTING WAIVERS TO — USE MEDICAID DOLLARS TO BUY PRIVATE INSURANCE FOR THE WORKING POOR WITH CO-PAYS, PREMIUMS, DEDUCTIBLES, ETC.. THIS ALSO HELPS RURAL HOSPITALS REMAIN SOLVENT.

    THIS WILL BE THE MODEL TO EXPAND MEDICAID AFTER THE FALL ELECTION!