NC Medicaid Choice Coalition to Support Reforms to Modernize North Carolina’s Medicaid Program in the 2015 Legislative Session
NC Medicaid Choice, a new coalition formed in support of reforms that modernize North Carolina’s Medicaid program, will advocate for systematic changes that deliver budget predictability for taxpayers and better health outcomes for Medicaid recipients. The Coalition supports legislation that shifts financial risk away from taxpayers by allowing traditional managed care plans, as well as plans offered by health care providers, to compete in the North Carolina Medicaid market.
North Carolina’s Medicaid program cost $13.3 billion last year, of which $3.4 billion was paid by North Carolina taxpayers. Despite the state’s large investment in Medicaid, North Carolina taxpayers still aren’t getting the value they deserve. Annual shortfalls in the state’s Medicaid program have averaged nearly $350 million over the past five years. Medicaid shortfalls and growing costs threaten funding for other important budget priorities such as education.
North Carolina is one of the few states that still relies on a fee-for-service Medicaid system that pays doctors primarily for the volume of services they provide rather than for quality of care and improved health outcomes for patients. Currently, 39 states have adopted Medicaid reforms that shift financial risk away from taxpayers to organizations that are paid a fixed fee set by the state to support the health care needs of Medicaid recipients and are accountable for meeting quality and other performance measures.
“While our state has made some progress toward better care coordination through Community Care of North Carolina, moving to a competitive model that shifts financial risk away from the state is the logical next step,” stated Taylor Griffin, spokesman for the NC Medicaid Choice coalition.
Allowing both traditional managed care and provider-led health plans that are willing to assume financial risk to care for Medicaid recipients would allow North Carolina to better control costs and prevent crippling budget shortfalls. The Coalition encourages state lawmakers to adopt a reform plan similar to those already working in other states that allows Medicaid recipients choice. Competition among plans would drive health care innovations that improve the quality of care and health outcomes.
“We strongly urge Governor Pat McCrory and members of the General Assembly to support an approach that incorporates traditional managed care plans as well as plans offered by health care providers,” Griffin stated. “A wider range of plan options will provide choice for Medicaid recipients and competition in the market that will raise the bar on delivering health care improvements for Medicaid recipients while also helping to control costs.”
NC Medicaid Choice members include: Aetna, Amerigroup, AmeriHealth Caritas, UnitedHealth Group and WellCare.