The Department of Health and Human Services presented a framework to reform the N.C. Medicaid program to the Medicaid Reform Advisory Group on Feb. 26, before an audience packed with providers and other interested parties at the auditorium of the State Library of North Carolina.
"What we are presenting today is a realistic and achievable plan that puts patients first, helps create a sustainable Medicaid program, and builds on what we have in North Carolina," said Secretary Aldona Wos, M.D. "This proposal represents a fundamental improvement in how the state delivers Medicaid."
This new framework is based on feedback from the two previous Medicaid Reform Advisory Group meetings, and from traveling to meet with stakeholders across the state. The framework takes the form of five recommendations to create a Medicaid system that rewards healthy outcomes:
Recommendation 1: North Carolina Medicaid services for physical health will be coordinated through accountable care organizations (ACOs) that share savings and losses with the state and are responsible for equity.
Recommendation 2: ACOs’ coverage of the population and financial accountability will rise progressively; DHHS will benchmark progress.
Mental health, intellectual/developmental disabilities and substance abuse services
Recommendation 3: Enhance the state’s Medicaid mental health, intellectual/developmental disability and substance abuse service delivery system.
Long-term services and supports (LTSS)
Recommendation 4: Streamline and strengthen case management for long-term services and supports.
Recommendation 5: Shape the ultimate direction of LTSS.
For recommendation details, click here.
The Medicaid Reform Advisory Group met Feb. 26 at the State Library/Archives and History Building in Raleigh. The comments shared at this meeting will contribute to furthering the dialogue between the Department and stakeholders. DHHS will formally present its plan to the General Assembly in March.
The advisory group was instructed by the General Assembly to serve as a forum for stakeholder input and to ensure transparency in the Medicaid reform process. It has held two prior public forums in December 2013 and January 2014. Presentations, handouts and videos from those meetings are available on the DHHS Medicaid reform webpage at www.ncdhhs.gov/medicaidreform.