NCMS Welcomes Shift Away from Medicaid Managed Care to Medicaid Reform That Incorporates ACOs

In a welcome shift for the North Carolina Medical Society (NCMS), the North Carolina Department of Health and Human Services (NC DHHS) presented a new Medicaid reform plan that shifts away from their initial proposal to use managed care organizations to control costs. Instead, DHHS officials offered the Medicaid Reform Advisory Group a plan that incorporates local accountable care organizations (ACOs), in which doctors share both cost savings for quality and efficiency of care as well as the financial risks. A similar approach was initially endorsed last March by the NCMS as a way to ensure quality patient care and a more predictable and sustainable Medicaid budget for the state.

“We applaud the Governor’s team for its willingness to embrace new approaches to Medicaid reform and believe those changes, rather than the traditional managed care models of the past, are in the best interest of all North Carolinians,” said NCMS EVP and CEO Robert W. Seligson after the presentation. “We believe that placing incentives for cost efficiencies and improvement of patient outcomes belongs with the people who take care of those patients. We are confident that with the right flexibility in the system and the latitude necessary to serve our patients to the best of our ability, the state will soon achieve its goals of cost predictability and long-term sustainability for Medicaid. Most importantly, our state’s most vulnerable citizens will receive the care they need, when and where they need it.”

Seligson’s remarks were picked up by many media outlets throughout the state including the following:

While there are still many details to be worked out, an overview of the DHHS’s presentation to the Advisory Group may be reviewed here. The Advisory Group will make a recommendation to the legislature, which will consider the proposal during the short legislative session in May.

“We look forward to working closely with the Governor, Department of Health and Human Services, and General Assembly to implement meaningful Medicaid reform in 2014,” Seligson said.


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