Today the North Carolina House Committee on Health will likely vote on HB 372, 2015 Medicaid Modernization. HB 372 includes many of the provisions the North Carolina Medical Society (NCMS) has been advocating for alongside other key stakeholders. Since the start of the Medicaid reform debate two years ago, we have been building support for a provider-led Medicaid reform solution, and this bill advances that objective. HB 372 recognizes the value of physician leadership in the delivery of health care and demonstrates the commitment of House leaders to have a system that controls costs while also maintaining high-quality health care. The bill calls for provider-led entities (PLEs) to transition over a six-year period of time to a capitated payment for Medicaid services, with an emphasis on quality measurement and performance-based payments. This legislation also requires that a majority of the PLE’s governing board be comprised of physicians treating Medicaid patients. The bill also includes a provision that would require that PLEs control the state’s cost growth at least two percentage points below national Medicaid spending growth as projected in the annual report prepared for CMS for non-expansion states.
While the bill will need further revision, it represents the beginning of an ongoing discussion on Medicaid reform. The Medical Society will continue to work to address issues in HB 372 and other reform plans to support the medical community’s goals of keeping clinical decision making at the forefront of any Medicaid cost savings and reform initiatives, while building on successful programs already in place in our state. We anticipate that the Senate budget will include a Medicaid reform proposal of their own, and it is expected that this plan will place a greater emphasis on corporate managed care. The Medical Society will continue to provide members with updates on the progress of HB 372 and the larger Medicaid reform negotiations at the General Assembly through our Bulletin announcements.