Under the Dome

Opponents to Medicaid privatization plan react

Three groups that fought the legislature’s plan to privatize state Medicaid released statements Friday saying they’re ready to work on the government insurance program as it is transformed.

The legislature will likely vote next week on the bill that would have a mix of commercial insurance and “provider-led” Medicaid managed care plans in the state.

The N.C. Medical Society, which objects to opening the state to commercialized Medicaid managed care, said there’s a lot more work to do before managed care kicks in.

Under the timetable, it’ll take four years or more before patients are enrolled in managed care plans. The Medical Society released a video of its lobbyist, Chip Baggett, describing House Bill 372 as “just a general framework” that will be filled in over time.

The statement from Medical Society CEO Bob Seligson says, “Medicaid reform is challenging, and we understand the difficulty of the decisions legislators are facing. We oppose the General Assembly’s decision to involve corporate managed care in our Medicaid program. Including some of the patient protections we requested such as performance standards based on quality, cost and patient experience is an improvement. This is not the end of the Medicaid reform debate. We will continue to work with our partners and the state’s leaders on the many decisions that lie ahead to enable the delivery of high value medical care to our state’s most vulnerable citizens.”

Community Care of North Carolina - networks of doctors who have contracts with the state to provide “medical homes” for most Medicaid patients - said they’re glad they’ll be around for a while. The state Senate had proposed shutting off money to CCNC by the middle of next year. The bill the House and Senate agreed to would keep CCNC around until the new managed care contracts begin.

The statement from CCNC says it is “pleased that the NC General Assembly has decided to continue the CCNC program through the Medicaid reform process. This will allow the state to build upon our statewide infrastructure and proven track record in saving money and improving the health of the 1.4 million North Carolinians who depend on us.

“We see a bright future for CCNC and expect to continue to play a significant role in improving Medicaid under the new system. We look forward to working with the Administration and legislature to make our state’s reform effort successful. We are confident that CCNC’s skills, people and relationships will continue to be much in demand, including the intelligent use of data, expertise in coordination of care and medication management, and a focus on maximizing the effectiveness of primary care and local resources.

“Numerous audits, studies and peer-reviewed articles have documented the strong results obtained by CCNC’s quality-first, clinician-led approach to care. In partnership with clinicians all across the state, we’ve reduced inpatient admission rates and readmissions, eased pressure on emergency departments and reduced the rate of low birthweight babies.

“We applaud state policymakers for allowing CCNC to continue to improve care, help our most vulnerable citizens and save NC Medicaid hundreds of millions of dollars a year while Medicaid transitions to a new model of payment.”

The N.C. Hospital Association said it’s still analyzing the bill.

“NCHA is continuing to evaluate the specifics of this complex legislation. We appreciate the inclusion of provisions in the Medicaid Reform legislation that prioritize funding to support patient care over insurance company profits, require DHHS to obtain federal waivers necessary to preserve essential hospital funding for patient care and establish a realistic timeframe for implementation of this new capitated system. NC hospitals and health systems stand ready to work with the Department and the General Assembly to ensure a sustainable and effective Medicaid program for the 1.9 million North Carolina children and families who rely on Medicaid for their care.”