While the problem-plagued NCTracks Medicaid Claims system was not discussed at this meeting, some new insights were revealed about the administration’s developing plans to reform the Medicaid system. These ideas include:
- Providers’ greater “assumption of risk” will be progressive over time.
- There would be a move away from fee-for-service to pay-for-value.
- The state would have five to seven regions in which provider groups, including accountable care organizations and managed care organizations would compete to enroll Medicaid patients.
- There would be three categories of Medicaid patients: 1) general, including mothers and children, 2) the mentally ill and developmentally disabled, and 3) institutional patients and those who are qualified for institutional care, but are receiving home and community services.
“The NCMS is strongly committed to working with the administration, department and legislature along with our health care partners to develop a viable and sustainable plan,” Seligson emphasized. “Our common goal is to improve access, efficiency and address the many challenges that must be overcome first in order to effectively reform the system.”
The administration hopes to present their plan to the General Assembly by March 17.
After the meeting, Seligson was able to speak one-on-one with Gov. McCrory and Sec. Wos as well as representatives from Duke University Health Systems, Carolina’s Medical Center, Vidant Health, and Novant Health systems. Also represented at the meeting were the North Carolina Academy of Family Physicians, the North Carolina Pediatric Society and Community Care of North Carolina.
The NCMS remains fully engaged in resolving the serious problems with NCTracks and ensuring that Medicaid reform improves medical care for our state’s most vulnerable citizens. What are your thoughts on the ideas presented above?