McCrory and Medicaid Reform
Published April 5, 2013
By Brad Crone
By Brad Crone
What’s the old adage, you can’t see the forest for all the trees? That’s what Governor McCrory is facing as he rolls out his big plans for Medicaid reform.
It’s a major initiative but it also has some serious political trappings, some even so deep that could threaten a second-term.
What Dr. Wos, Secretary of Health and Human Services and Medicaid Director Carol Steckel have overlooked is the Community Care of North Carolina program. CCNC is a North Carolina-based solution, it’s an existing program and it’s working.
Community Care of North Carolina is a collaboration between the state’s doctors and hospitals with the Medicaid program. CCNC is the only program in the state with “in-the-field” nurses and health care professionals coordinating care programs with Medicaid patients, their doctors and the hospitals.
It’s working. The program saved the state nearly $90 million last year and the Kaiser Foundation recently reported that North Carolina had the lowest rate of growth in its Medicaid program than any other state in the nation.
The CCNC model ensures that Medicaid health patients have a “medical home” that works with the patients to ensure they are getting the care and assistance they need.
The CCNC program already has existing networks in all 100 counties. They have the relationships with the hospitals and doctors. They are a North Carolina success story that other states are looking at to replicate.
It doesn’t make any sense to bring in an outside private insurer to offer a managed care Medicaid program. That solution is short-sighted. It will impact the delivery of care and potentially dismantle a successful patient-focused program like Community Care of North Carolina.
Let’s hope the Governor will instruct Secretary Wos and Medicaid Director Carol Steckel to slow down a little bit and take a look at what is working and figure out how you can take what’s working and expand it. Dr. Wos and Director Steckel would be prudent to meet and talk with the folks at CCNC and really learn that they are doing on the ground.
There is little doubt that embracing CCNC would be a wise choice because it offers a sound public policy solution and helps the Governor avoid and all-out war with the state’s medical community.
April 7, 2013 at 11:02 am
Bob Quinn says:
Brads comments sound like a sales pitch for the existing program. Since he is a lobbyist his comments don't have a lot of credibility.
April 10, 2013 at 3:34 pm
Teresa Lee says:
I don't believe you will find any potential "savings" from CCNC. In fact the vast majority of medicaid patients I have spoken to at the hospital (I am a clinical social worker) have never heard of this. They don't know they are in a CCNC network, they don't know anything about any "home" program they are reportedly involved in yet CCNC gets a monthly premium on every single medicaid enrollee regardless of that patient's needs or use in the system. It is also my understanding from others who work at NC Medicaid that patients are typically not removed from the medicaid system for 3-5 months after they have either died or had benefits terminated. While they stay in the system CCNC continues to collect that monthly premium. This is yet another one of the no bid contracts that NC has attached to the NC Medicaid system. This program goes unchecked and can provide no metrics to show its worth. In theory it should be a life saver. It is my personal experience with working with thousands of these recipients that the practice is nothing like the theory. This is a broken program where dollars that should be spent on healthcare for needy recipients is being shunted instead to another "special project" set up by a politician.
I agree 100% with Bob Quinn who states that article was nothing more than a sales pitch. The lobbyist even included a veiled threat about the Governor's re-election potential.
As I wrote earlier a company like United Heatlhcare has a real track record of taking over and administering other state medicaid programs, taking thousands of workers off the state payroll as well as ensuring that services are rendered, approved and paid for in a timely and appropriate fashion. The state auditors report already listed several of the states covered by United in their report. You know the comparable sized states with far lower costs........
