In April Governor Pat McCrory and Secretary Aldona Wos launched The Partnership for a Healthier North Carolina as the framework for a statewide overhaul of the Medicaid delivery system. The partnership was developed with input from stakeholder groups, including consumers, providers and advocates, over the past few months.
More than 160 responses came after DHHS issued a Request for Information. Medicaid Director Carol Steckel and her staff reviewed all the responses and developed the basic concepts of the framework, but as Dr. Wos stated in the news conference, the work to build a “sustainable and predictable system for the future” has just begun.
“We need creative and innovative ideas from the public and private sectors to make this vision a reality,” Wos said. “We are inviting everyone to join us in creating a Medicaid system that cares for the whole person, increases preventive care and reduces the need for more expensive, inefficient emergency care.”
The framework is centered on the formation of approximately three Comprehensive Care Entities, which will be responsible for coordinating physical and behavioral healthcare for all Medicaid recipients. The CCEs will build or partner with existing providers or networks to ensure each individual will receive the right care at the right place and at the right time based upon their needs.
“We saw several common themes in the responses we received to the RFI, including our disjointed IT system and too much administrative duplication,” Steckel said. “But there was also agreement that our Medicaid system did not look at a person as a whole, separating physical health and mental health and even substance abuse into different silos of care that didn’t collaborate to improve patient outcomes. If our goal is to help our citizens become healthier, we need to find out what is working and build on that to accomplish that goal.”
The current Community Care of North Carolina (CCNC) program, as well as the managed care organizations supporting behavioral health services across the state, have demonstrated the value of managed care, but Steckel and Wos say it is time to take those models as well as the good and bad lessons learned by other states to a new level.
Secretary Wos and Steckel have already begun traveling across the state, holding meetings with hospital officials, doctors and other providers. In addition, they have announced regular office hours and “doctor days” to provide information about the framework and to solicit ideas and input from stakeholders. An RFP for the formation of the Collaborative Care Entities is expected to be ready by January 2014, with a program launch planned by July 2015.