State Medicaid office looking outside for ideas

lbonner@newsobserver.comFebruary 13, 2013 


Dr. Aldona Wos is head of the N.C. Department of Health and Human Services.


The state Department of Health and Human Services is going outside the agency in search of ideas to improve Medicaid.

The state Medicaid office wants ideas on changing the ways health care providers are paid and for making recipients more responsible for their health and payments for medical care.

The government health insurance program for the poor and disabled covers about 1.5 million people in the state. The state and federal governments share the $14 billion annual cost, with the state paying about $3 billion.

DHHS Secretary Aldona Wos told legislators Wednesday that improving Medicaid and the department’s computer systems were her twin priorities.

Both have been criticized in state audits over the last two years. An audit late last month suggested Medicaid administrative costs are too high and that program officials did not properly forecast costs from year to year.

Carol Steckel, the state’s new Medicaid director, voiced support for the state’s Medicaid managed care program, Community Care of North Carolina, calling it a “state of the art” program that other states want to copy.

“The goal is to build on what exists,” she said.

CCNC has been hailed for its effectiveness in linking patients to primary care doctors, but the state audit released last month invited questions on how well it holds down costs. State Auditor Beth Wood said her office and the legislature’s program evaluation division where discussing which would take a deeper look at Community Care.

The agency is looking for new ideas by March 15 on how to pay providers based on results, not just how often they see a patient. The Medicaid office is encouraging ideas on patient co-payments and deductibles.

“I don’t need to tell you that Medicaid needs improvement,” Steckel said.

Joseph Cooper, the agency’s new head of information technology, said a Medicaid billing system that has suffered from delays and cost overruns will be ready July 1.

DHHS is one of the state agencies under the closest scrutiny. Wos put the reports the agency is required to produce for legislators at 150 a year.

Wos asked for some relief, saying that the required reports really didn’t give legislators information they could use.

Wos also complained that DHHS staff members were submitting reports that were months late, “stuffed with acronyms and lots of fluff.”

“Some were so industry-specific that no person could decipher what was trying to be relayed,” she said.

Wos said she was committed to getting legislators information they can use by report deadlines. Staff who fail to adhere to the new reporting requirements are getting warning letters in their personnel files, she said.

Bonner: 919-829-4821

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