NCMS Among Other Health Care Groups Looking to ACOs to Reform NC Medicaid

At the Medicaid Reform Advisory Group meeting last Wednesday, North Carolina Medical Society (NCMS) President Dev Sangvai, MD, was the fourth person of the approximately 50 representatives of health care groups and individuals, to address the panel on ways to reform the state’s Medicaid program.

Sangvai’s recommendations focused on accountable care organizations (ACO) that are proving effective models with Medicare and with practices throughout the state.

“Adoption of value-driven principles, which are already proving effective in ACOs like Coastal Carolina Health Care in New Bern, would accomplish the state’s goals of budget predictability and sustainability for Medicaid as well as treating the whole patient,” Sangvai told the panel. “Coastal Carolina recently shared quarterly results of 25-30 percent savings for their Medicare/Medicaid dual eligible patients.”

Hospital and other provider group representatives echoed the NCMS’ position and a consensus seems to be building that this model is a viable alternative to the Governor’s plan to turn Medicaid over to private managed care companies.  

As Sangvai pointed out, “Right now there are Medicare-approved ACOs that geographically cover 50 percent of North Carolina’s population. With the addition of other qualified ACOs, the large majority of Medicaid recipients could be in a value-driven arrangement in less time than it would take to implement a traditional managed care program.”

Journalist Scott Mooneyham, who writes for the Insider, a newsletter that many policymakers read, noted in an article over the weekend that Governor McCrory, during a news conference, “did not specifically endorse the accountable care organization model that doctors, hospitals and other health care providers have indicated they see as a reasonable reform of the health care program for the poor. The governor did, though, make several comments that appeared in line with that type of change and with gaining the support of health care providers. ‘That is going to be one of our greatest challenges, getting consensus,’  McCrory said in response to a question about the reform efforts.”

The NCMS will continue to work closely with the Advisory Group, the McCrory administration and other groups to arrive at a consensus that serves patients and their doctors as well as the state’s goals of budget sustainability and predictability over time. Watch the Bulletin for updates.


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