NCDHHS and NC HIE Take First Significant Step Toward Medicaid Reform

The NC Department of Health and Human Services (DHHS) announced on Tuesday they have signed an agreement with the NC Health Information Exchange (HIE) to allow sharing of clinical data among those who care for North Carolina’s Medicaid patients.  This agreement is the first significant step toward meaningful Medicaid reform because it will provide NCDHHS with a more comprehensive health profile of the patients in the Medicaid program.

The NC HIE is an absolutely essential element in the value-based accountable care organization (ACO) model proposed in the Governor’s recent plan for Medicaid reform. Health care is moving from a flawed system that pays providers for the volume of care a patient receives to a system that rewards the outcomes and quality of the care provided. In order to treat the whole patient, a doctor must have all pertinent information about that person’s care regardless of where it was administered. The NC HIE offers a neutral and robust source for that information. With this data, the state will be able to establish meaningful benchmarks to measure the success of a value-based model like ACOs.

“We are encouraged by the signing of this agreement. The first block in the foundation for meaningful Medicaid reform has been placed,” said Robert W. Seligson, CEO of the North Carolina Medical Society (NCMS). “Of course, the ultimate goal is to serve patients – to keep them healthy and to treat them with the best clinical care in the most efficient manner. The data available through this exchange will help boost quality outcomes, enhance coordination of care, provide greater transparency and, in the long run, drive down costs for the Medicaid program.”




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