On June 1, North Carolina will submit for the federal government’s approval a historic proposal with the goal of promoting greater quality of care and greater value to the Medicaid patients, health care providers and taxpayers of our state.
This proposal – the result of legislative reforms enacted last year, months of work by state health officials and ample opportunities for input from stakeholders and the public – is a hybrid approach that encourages the involvement of both managed-care organizations and provider-led health entities in order to promote competition, innovation and more choices for patients.
The NC Association of Health Plans appreciates the opportunity to work with physicians and providers all across North Carolina as managed care moves forward in our state.
Many of our association members have years of Medicaid experience in other states, and we know that the doctors who care for the 1.9 million Medicaid and N.C. Health Choice patients in our state are the key to successful managed care in North Carolina. That’s why, even though the state’s proposal has not yet been submitted for federal approval, we have already begun reaching out to provider groups to discuss ways we can work together to minimize administrative burdens on providers while bringing greater value to their practices.
Additionally, 12 of the 15 potential managed-care capitated opportunities in this plan have been set aside for provider-led entities. These provider-led entities – which can be for-profit or not-for-profit or ventures combining different types of organizations and different provider groups – allow for physicians to continue to both compete and participate in an innovative environment.
The legislative reforms that have brought us to this point are grounded in a vision of providing value, maintaining access and innovating care models. They are meant to build upon the successes and lessons learned in the past. Most of all, they offer a tremendous opportunity for all of us involved in the business and delivery of health care to work together to deliver the highest-quality care and service to Medicaid patients throughout North Carolina.
Executive director, North Carolina Association of Health Plans
The length limit was waived.