NCMS Works Hard To Refine Medicaid Reform Proposal

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For the last month, North Carolina Medical Society (NCMS) staff has been working closely with the North Carolina Hospital Association and other provider groups to fashion a framework for Medicaid reform in North Carolina. The many early morning and late night meetings have resulted in a high-level statement of principles that all parties can accept. Read the NC Provider Community Medicaid Reform Proposal.

This document is an important step in what will likely be a long process of working through the many minute details to make this vision into a legislative reality. The NCMS appreciates the valuable participation and input of the state medical specialty organizations. We are moving toward what we hope will be meaningful Medicaid reform, which takes into account the various interests of the health care community, taxpayers and, most importantly, the patients who receive Medicaid services.

The proposal’s overarching goal is to pursue the Triple Aim:

  • Reducing the per capita cost of health care;
  • Improving the health of populations; and
  • Improving the patient experience of care (including quality and satisfaction).

The organizations delivering the care would be governed and led by providers, who would take on the state’s financial uncertainty over Medicaid enrollees’ utilization of services through capitation. These provider-led entities would then have a vested financial interest in delivering efficient care for Medicaid enrollees. The ultimate goal would be to integrate physical health, mental and behavioral health, long-term services and supports, with the move to capitation expanding to all those groups over time.

This is a work in progress, and the legislature has indicated, while they want to enact Medicaid reform this session, it may not happen before the budget is complete. The NCMS would like to hear your thoughts on Medicaid reform. Please email [email protected] with your comments and questions.




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