NCDHHS Seeks Input on Medicaid Transformation
DHHS issued a press release this week seeking input in the transition to managed care (News and Observer story). The release was accompanied by a detailed memo outlining the areas the department was seeking input. These included how NC’s Medicaid program should:
- Care for the whole person to improve physical and mental health
- Help health care professionals transition to managed care
- Manage care to improve overall health, not only to treat injury or illness
- Consider how income, housing, lifestyle, etc., affect health and health care services
- Improve the quality of care
- Pay for value
- Increase access to care and treatment of substance use disorder
Four public hearings have been scheduled, the first of which will be Monday in Greensboro. The other three will be in Greenville (May 10), Asheville (May 12), and Raleigh (May 16).
Debate Over Medicaid Expansion in NC Continues
On newspaper opinion pages around the state, the debate over Medicaid expansion continued to rage this week. WRAL argued in an editorial that “The lack of expansion of Medicaid is both morally bankrupt and fiscally inexcusable.” Katherine Restrepo, director of health care policy for the John Locke Foundation, a conservative Raleigh-based think tank disagreed. Writing in the Wilmington Star-News, Restrepo said that expanding Medicaid would be a mistake. “Rather than extend the reach of Obamacare, state lawmakers should do what they can to make health care itself more affordable.”
Despite Conservative Support, GOP Obamacare Replacement Remains Stalled
Last week Republican’s floated a new Obamacare replacement in hopes of getting a vote before Trump’s 100-day mark. While the new bill won support from conservative members of the House Freedom caucus, whose opposition sunk House Speaker Paul Ryan’s American Health Care Act, no vote came this week. Nor is one likely anytime soon. In a press conference Thursday, Speaker Ryan said that leadership will hold a vote when there’s enough support to pass a bill. “We want to go when we’re ready to go,” Ryan said. “This has been a very organic, bottom-up process. It takes time to do that.”
Managed Care Lessons from the States
Modern Health Care looked at Medicaid managed care problems in Illinois, Iowa, and elsewhere for lessons on effective implementation. “Strong administrative processes at the state and plan level are key to making Medicaid managed care work,” they concluded. The report stressed good working relationships between providers and MCOs and focusing on whole person care as important for success.
Managed Care Important in Medicaid Expansion States
The Kaiser Family Foundation analyzed the link between managed care and Medicaid expansion in a data note out this week. The report found that the “larger increases in MCO enrollment in the Medicaid expansion states reflect a number of factors, including: the greater number of expansion versus non-expansion states with MCOs; the much larger number of Medicaid beneficiaries residing in the expansion/MCO versus non-expansion/MCO states (43.1 million versus 18.1 million in December 2016); and the expansion states’ heavy reliance on MCOs to serve newly eligible adults as well as other Medicaid beneficiaries.” Indeed, according to Kaiser, “[e]xpansion states account for 15 of the 21 states where more than 80% of Medicaid beneficiaries are in MCOs.”
Ohio Touts Medicaid Managed Care Success
A new report from MyCare Ohio says that managed care is saving the state $2.4 million a month and has improved coordination of care. The report said that nearly 82 percent if beneficiaries had an assessment of health needs completed within 90 days in 2016, up from 61 percent in 2014. Problems with payment delays to providers have largely been resolved the report said, with 90 percent of claims paid within 30 days, and nearly 99 percent within 90 days. All this shows managed care is working Greg Moody, director of the Governor’s Office of Health Transformation, told the Columbus Dispatch. So the question for lawmakers is: “Why not offer managed care to more people?”
Provider-led Medicaid Accountable Care Organizations Working in Rhode Island
Complaints about Rhode Island’s managed care program from providers have turned to praise after the state decided to allow Medicaid ACOs. Dr. Jim Fanale, chief clinical officer at Care New England, a multisite health system in Rhode Island told Modern Health Care that the ACO experiment has reduced costs and resulted in better care for the sickest Medicaid beneficiaries.