At a time when the Affordable Care Act is under constant partisan fire despite its successes, when lawmakers in North Carolina look to cut health care benefits, when Medicaid, the federal/state health plan for the poor and disabled, is stretched thin – Community Care of North Carolina is a bright light. It works. It works very well.
Well enough, in fact, to win a prestigious national recognition, the Hearst Health Prize, for $100,000. It comes from Hearst Health in partnership with the Jefferson College of Population Health of Thomas Jefferson University. The prize cites Community Care for its success in managing and improving the health of its clients.
Community Care manages transitional care for people on Medicaid who have been discharged and sent home after hospitalization. Its services include helping people manage their medications and monitoring their health through a system that keeps them in touch with providers. It also can help them with transportation or substance abuse issues – basically everything that can have an impact on their health.
The prize represents tangible evidence that Community Care is respected nationally and is a model for others. In North Carolina, those it has served – and by multiplication, those who know those it has served – have seen that it works.
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Those helped by Community Care show substantially lower rates of readmission to hospitals, and thus Medicaid costs are reduced. The system’s also efficient, putting Community Care and physicians in direct contact with hospitals, for the purpose of sharing data. This, too, is a cost-saver.
Some Republican lawmakers have a notion of turning over the kinds of services Community Care provides to managed care companies that will take a lump-sum payment, out of which they’ll pay Medicaid recipients’ expenses. The flaws in that plan are obvious, first among them being the inability to answer the question: If the lump sum runs out because the managed care company needs its profit margin, what happens to the people it’s supposed to serve? The answer is those patients go wanting.
Community Care works. Expanding it would mean more people served, better health, more efficiency both in terms of finances and the health of clients. Community Care proved its worth long ago. But this national honor is a timely reminder.