NCMS Morning Rounds 3-12-21

It’s Friday and here is your NCMS Morning Rounds 

March 12, 2021

NC Population Health Collaborative Gets Ready for Medicaid Transformation

The NC Population Health Collaborative met yesterday to hear from the NC Department of Health and Human Services (NCDHHS) NC Medicaid transformation team on the status of the state’s transition to Medicaid managed care.

The over 100 participants in the virtual meeting heard that this long-awaited transition is on track to officially launch on July 1. As Deputy Secretary for NC Medicaid Dave Richard said: “Unless there is something catastrophic and unforeseen that happens, we will launch on July 1.”

Richard also answered the commonly asked question — ‘why make this major transition during a pandemic?’ The first, practical, answer is that it’s the law, he said. After a delay in budgeting for the transformation, the Governor and legislators agreed the process needs to move forward and, thanks to a bipartisan effort, the resources are now available to do so. Second, the program as designed allows for health improvements that are more easily accomplished through a managed care model, Richard said.

“The longer we wait, the longer it takes to get to these good things,” he said, describing the program goal “to address medical and non-medical drivers of health through an innovative, whole-person centered, well-coordinated system of care.”

Other speakers addressed the transition and its direct impact on individual medical practices and patients. All agreed that challenges exist and there will likely be hiccups in the process. Some of those difficulties may include COVID-19 impacts, provider contracting, legislative changes and the state budget, Richard said.

Assistant Secretary for NC Medicaid Administration and Operation Jay Ludlam, JD, strongly encouraged all providers to contract with the state’s five selected pre-paid health plans (PHPs), preferably all five, as soon as possible. He said the complex process of ensuring the plans are ready and that patients will be served on day one is on track, adding that the Department has between 650 and 800 people working toward the successful launch on July 1. He also answered a variety of questions including several about reduced reimbursement if a physician or PA is not contracted with one of the plans and sees a Medicaid patient. Both he and Richard reiterated that the aim is to make sure ‘people get seen and providers get paid.’ Questions can be directed to the provider Ombudsman at 919-527-6666 or

NC Medicaid Director of Quality and Population Health Kelly Crosbie offered information about additional payments to medical practices that begin patient screenings now for unmet health-related needs as part of the Healthy Opportunities referral program. She also spoke about the time-limited payments to practices that have attested as an Advanced Medical Home (AMH) Tier 3. The payments, called “AMH Tier 3 Glidepath Payments,” will be $8.51 per member, per month (PMPM), and will be added onto existing Carolina Access Medical Home payments your practice currently receives. The functionality to attest to an AMH Tier 3 provider is now live in NCTracks. Practices must complete attestation by March 30, 2021 to be eligible for payments beginning in April, however, you will have additional opportunities to complete attestation and receive payments for May and June. For more information, visit Advanced Medical Home Tier 3 “Glidepath” Payments Update.

NC Medicaid Chief Medical Officer Shannon Dowler, MD, encouraged practices to attend her ongoing ‘fireside chats’ (soon to be renamed ‘poolside chats’ with the warmer weather), to keep up to date on the progress toward the July 1 launch of Medicaid managed care and to get questions answered. See the Learning Opportunity section of this newsletter to learn more and register for these webinar sessions.

A recording of the entire Collaborative meeting will be posted on the NCMS website at this link on Monday, March 15, the place to access all the valuable information shared.

The NC Population Health Collaborative brings together representatives of existing NC Accountable Care Organizations (ACOs) and aspiring ACOs participants and partners. The Collaborative provides an opportunity for emerging and developing ACOs to share experiences and ideas about transitioning to accountable, value-driven, health care delivery systems, and to identify and discuss possible solutions for facilitating that transition. The Collaborative meets twice a year. The next meeting will be held on Sept. 9, so mark your calendar and watch for details in your NCMS Morning Rounds.

Explore the Possibilities of Running for Public Office

If you’ve ever toyed with the idea of running for public office, the AMPAC Candidate Workshop is a great place to learn more about what is involved. This year the workshop will be held virtually due to the pandemic and offers the opportunity to explore the possibilities without having to travel. AMPAC Candidate Workshop will be conducted virtually this year.

The AMPAC Candidate Workshop will teach you how to run a winning political campaign, and is designed to help you make the leap from the clinical exam room to the campaign trail, offering the skills and strategic approach you will need to make a run for public office. Learn more here.

To provide the same high-quality content of the in-person program, the Virtual Candidate Workshop will be conducted over the course of two consecutive weekends: May 1-2 and 8-9. Both weekends are part of the full program and must be attended by participants. Each of the four virtual sessions will start at 11 am and run approximately four hours.

At the Candidate Workshop, political veterans from both sides of the aisle will give you expert advice about politics and the sacrifices needed to mount a competitive campaign. You will learn: how and when to make the decision to run; the importance of a disciplined campaign plan and message; the secrets of effective fundraising; what kinds of media advertising are right for your campaign; how to handle the inevitable crises that emerge for every campaign; and the role your spouse and your family will play.

Note: Registration fee is $250 for AMA Member/$1000 for non-AMA members. This fee is waived for AMA residents and students; however, space is limited and the AMPAC Board will review and select four participants from the pool of qualified resident and student applicants.

Registration for the Virtual Candidate Workshop is now OPEN. Space is limited and the deadline to register is April 9.

For more information please contact:

Or Perhaps Become a Candidate for NCMS ‘Office’

Nominations to serve on the NCMS Board of Directors, AMA delegation, Nominating and Leadership Development Committee as well as the NCMS Foundation (NCMSF) Board of Trustees are now being accepted for the coming year. If you are interested in a leadership role or know someone who you would like to nominate as a good candidate, learn more at the links below.

The NCMSF, the philanthropic arm of the NCMS, seeks to improve access to quality health care for all North Carolinians. The Foundation’s portfolio of programs demonstrates our commitment to this vision. Learn more about each of these programs here.

A full description of what is expected of members of the NCMSF Board of Trustees along with details on the nomination process are outlined in this document. Nominations are due by Aug. 30, 2021.

The NCMS’ Nominating and Leadership Development Committee is seeking nominations for individuals to serve on the NCMS Board of Directors, NC American Medical Association (AMA) Delegation and on the Nominating and Leadership Development Committee itself. Nominations are due by May 17, 2021.

An overview of each of the roles on the NCMS Board of Directors, AMA delegation and Nominating and Leadership Development Committee along with details on the nomination process are included in this document.

In the News

A Pandemic Expert Weighs In On The Long Road Ahead For Covid-19 Vaccine Distribution, STAT News, 3-8-21

Learning Opportunity

Advanced Hot Topics in Medicaid Transformation, Thursday, March 18 | 5:30- 6:30 p.m.
This series is designed to support practice managers, quality improvement professionals, care coordinators and others within practices who are responsible for meeting the NC Medicaid AMH Tier 2 or 3 requirements.

Topics include:
• Panel management
• Healthy Opportunities screenings
• Health Equity survey & payments
• Glidepath payments
• Network adequacy
• Meet & greet with Health Plans
• Q&A

Learn more and register here.

If you have policies you’d like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!



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