Resolution 14: Support of the Study of a Capitated Medicaid System

Introduced by:  Charles W. Henrichs, MD – Delegate, Henderson County Medical Society

Referred to:        Reference Committee No. 1 – Timothy M. Beittel, MD, Chair

WHEREAS, Medicaid in this state and across the nation is facing severe and dramatic reimbursement cuts; and

WHEREAS, with these reimbursement cuts it is expected more providers will opt out of treating Medicaid patients except under compulsion; and

WHEREAS, the growth of patients requiring Medicaid is certain to grow; and

WHEREAS, North Carolina predominantly uses a fee for service system to fund Medicaid; and

WHEREAS, there is a very clear movement across the state towards physician employment in larger hospital systems; therefore be it

RESOLVED, That the North Carolina Medical Society supports a study to develop a capitated system of delivery of care for Medicaid patients.  (policy)

Fiscal Note:  No additional funding above current resources estimated.  Current resources will be allocated based on the priorities of the Society and the NCMS budget.

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  • The NCAFP strongly opposes this resolution. North Carolina currently has an excellent system in place for managing and coordinating the care of Medicaid patients which is nationally recognized and has produced significant cost savings for the state. Community Care of North Carolina is a model for high-quality, cost-effective care of both the Medicaid population and now Medicare recipients and some private insurance plan participants. We would oppose anything that negatively impacts this system of care. These comments are on behalf of the delegation representing the N.C. Academy of Family Physicians — Dr. Brian Forrest, Dr. Shannon Dowler and Dr. Tom White.

  • Sandra Brown

    I oppose this resolution. I think maybe the author doesn’t understand the economics of capitated care? CCNC is one of the most effective models developed to care for medicaid patients because it was developed from the trenches.

  • Doug Sheets MD

    I oppose this resolution. It would be impossible for small practices or even midsize practices to have a large enough volume to be able to project their costs and a cavitated system could bankrupt these practices if they choose incorrectly.

  • Joseph Inglefield

    I have had the opportunity to talk to a group called the “Breakfast Club” in Hickory. This is a group of people who care for loved ones with severe mental and physical handicaps in their own homes. This saves the state millions and now their services are being cut due to “managed care” by organizations that have policys that make it increasingly difficult to keep these loved ones at home. They have been told quit working, and you will do better off by putting themselves on welfare, or institutionalizing those that are being cared for. Unbelievable advice contrary to the spunk and dedication of these care-takers. If you are going to “manage” care anything put everyone on it, including the governor, and all the legislators.

  • Charles Henrichs MD

    This resolution was submitted on behalf of Scott Donaldson MD, Henderson County, NC Medical Society member.

  • Michelle Jones

    I oppose this resolution. We need to educate physicians in the state about CCNC, it’s savings to the state and encourage all physicians to participate

  • Robert Monteiro, MD

    I oppose this resolution as we have been working closely with CCNC to continue to develop a highly regarded delivery system for Medicaid that is constantly evolving. CCNC has demonstrated remarkable success in savings and quality.

  • Joseph Inglefield

    Hasn’t this been tried in other states? I think NC has a model that works great with community care NC. We as a state don’t need to let this type of experimentation on our poor, disabled, and children, we failed with our mental health “reform”. Why don’t we just all have the same insurance coverage that the governor and the legislators have? Seems fair. This kind of experimentation would be turned down by any reasonable IRB.