A key feature of the joint venture will be the active participation of physicians in the ownership and governance of the health plan. Centene will manage the financial and daily operations, while the Carolina Complete Health Network, which will be owned jointly by NCMS, physicians, physician assistants, nurse practitioners and Federally Qualified Health Centers, will provide medical management services, hold a majority on the Board of Directors and oversee the medical policies for the health plan. This partnership seeks to engage all North Carolina physicians including those in primary care specialties like pediatrics, family medicine and obstetrics and gynecology as well as hospital-based physicians and the wide diversity of specialties and sub-specialties necessary to serve the Medicaid population of the state. We view all of these groups as significant contributors to the success of this endeavor.
“With the changes taking place in our health care system at the state level with Medicaid reform and new programs at the national level, the NCMS remains committed to ensuring that physicians are the ones making the clinical decisions in the best interest of their patients,” said NCMS CEO Robert W. Seligson. “Our leadership views this partnership as a unique opportunity to help lead the reform process and to put patients’ needs first.”
Work will begin shortly to prepare to submit a proposal when the state issues its Request for Proposal (RFP) in late 2017 in hopes that Carolina Complete Health will be selected as one of three statewide health plans authorized by the Medicaid reform legislation to offer care to Medicaid beneficiaries in North Carolina.
Carolina Complete Health is a new style of health plan that is patient-focused and predicated on the belief that physicians know what is best for their patients. This health plan upholds the values of the NCMS which we have advocated for over the past four years as the state reforms its Medicaid program – values at the very core of our mission: To provide leadership in medicine by uniting, serving, and representing physicians and their health care teams to enhance the health of North Carolinians.