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Originally published: 2014-03-21 11:09:56
Last modified: 2014-03-21 11:10:41

DHHS presents Medicaid reform plan to legislators

by Staff Reports

The North Carolina Department of Health and Human Services on Monday presented its Medicaid reform plan to the General Assembly, calling it a "realistic and achievable" plan that puts patients first, improves whole person care, ensures a more predictable Medicaid budget and builds on what already works for North Carolina.


"We have an obligation -- an obligation we have willingly accepted as a state -- to help those in need. And we must, at the same time, be good stewards of taxpayer resources," said DHHS Secretary Aldona Z. Wos, M.D. "We believe this Medicaid reform plan is responsive to both those obligations."


The plan proposes that providers collaborate through accountable care organizations (ACOs), a model that allows physicians and other providers who care for patients to take control of improving quality and healthy outcomes.


"When ACOs share in the savings or losses based on quality measures, everyone has a vested interest in making Medicaid a success," said Wos. "We expect the ACO model to bend the cost curve by approximately 2 to 3 percent, which would mean hundreds of millions of dollars in savings for the state."


The reform plan is based on input received during nearly 15 months of discussions with stakeholders throughout the state, including beneficiaries, caregivers, providers, health care organizations and the work of the Medicaid Reform Advisory Group.


DHHS is taking a dual approach to Medicaid reform as efforts also are under way to improve the Division of Medical Assistance (DMA) operations to support Medicaid reform.


Wos recently named Deputy Secretary of Health Services and Acting State Health Director Robin Gary Cummings, M.D., to lead the DMA transformation. He is overseeing efforts to improve existing operating processes to increase forecasting accuracy and deliver Medicaid services more efficiently and effectively.


Since its inception in 1970, the N.C. Medicaid program has evolved into an essential component of the state's health care system. It currently serves about 1.8 million low-income parents, children, seniors and people with disabilities and requires $13.5 billion a year to operate.


Medicaid Advisory Group members include Dennis Barry of Greensboro, chair, CEO emeritus of Cone Health; Peggy Terhune, Ph.D., of Randolph County, executive director and CEO of Monarch; Richard Gilbert, M.D., of Mecklenburg County, former chief of staff for Carolinas Medical Center; state Rep. Nelson Dollar of Wake County and state Sen. Louis Pate, who represents Lenoir, Pitt and Wayne counties.


To view a copy of the proposal, visit http://www.wataugademocrat.com.