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Medicaid Reform Minute #1: Why Reform?

Medicaid Reform Minute #1: Why Reform?

Medicaid Reform Minute #1: Why Reform?

With the NC Department of Health and Human Services (NCDHHS) announcing in February the new managed care entities that will be contracting with the state and providers, roll out of the new model will be quickly underway and important to understand. What are the goals of this reform?

1. BUDGET PREDICTABILITY
Under Medicaid Managed Care, the NC Legislature will pay fixed monthly (“capitated”) payments to managed care organizations, who are responsible for delivering medical care within those budget limits.

2. INTEGRATING PHYSICAL AND BEHAVIORAL HEALTH
Over the next several years, Medicaid Managed Care will phase in whole-person care for both physical and behavioral health. 

3.  ADDRESSING SOCIAL DETERMINANTS OF HEALTH 
Medicaid Reform will focus on addressing unmet social needs of patients in a variety of ways, including screening for Social Determinants of Health, establishing a statewide community resource directory, and using funds to pilot new community initiatives.

4. BUILDING ON WHAT IS WORKING WELL IN NC TODAY 
North Carolina’s model builds on the successful Carolina Access II and CCNC Care Management programs, where providers have been engaged with population health efforts for many years. In addition, NC will be the 33rd state, and the last large state, in the USA to move to Managed Care.

Source: https://files.nc.gov/ncdhhs/ProgramDesign_MediaRelease_REVFINAL_20170808.pdf


This Medicaid Reform Minute is provided courtesy of a partnership between Community Care of Western North Carolina and the Western Carolina Medical Society. For questions about this content, contact pmahoney@communitycarenc.org