Opportunities Remain for Meaningful Medicaid Reform in 2015

At a Joint Legislative Oversight Committee on Health and Human Services earlier this week, legislators voted to send their report on to the full General Assembly outlining only the general principles they would like to see included in any Medicaid reform initiative. At the final committee meeting of the year, specific recommendations, including having outside managed care corporations in the reform mix, were removed, leaving the door open for the legislature to introduce a reform plan that would focus on provider-led, value-based alternatives.

The North Carolina Medical Society (NCMS) has strongly endorsed this approach since the debate on Medicaid reform began nearly two years ago. Since that time, the NCMS has worked closely with the McCrory administration and legislators to demonstrate the advantages of a homegrown, provider-led solution to the inefficiencies and budget unpredictability that has plagued the Medicaid program for years.

Removing the specifics from the committee’s final report was thanks to an amendment put forward by Rep. Nelson Dollar, the House’s senior budget writer and a legislator familiar with the financial impacts of the various Medicaid reform scenarios for providers and the state’s coffers.  At the committee hearing on Tuesday, Dec. 9, Aldona Wos, MD, secretary of the North Carolina Department of Health and Human Services spoke passionately in favor of not rushing to install managed care organizations as a quick fix to the financial problem, but to take the long-view and develop a comprehensive plan that focuses on preventing illness and coordinating care for chronically ill patients – that falls squarely on providers. This approach will be the most sustainable way to save the state money.

Wos said provider-led care networks will lead to better patient health, but they need time to become established. “If we move too fast,” she said, “we will do more harm than good.”

Advocating for a physician-led Medicaid reform plan is an NCMS legislative priority for the upcoming session and will be a topic at the NCMS Legislative Cabinet meeting on Jan. 7, 2015 at 6 p.m. in Greensboro.


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