The NC Department of Health and Human Services unveiled its plan on Monday to reform the state's Medicaid system. While it had already signaled a shift from Managed Care Organizations (MCOs) to Accountable Care Organizations (ACOs) months ago, the new plan partially outlines how the state would like to achieve that shift.
The new plan hopes to persuade healthcare providers into ACOs to make them more responsible for the quality of their work with patients who are low-income, elderly, or who have disabilities. The idea is that the providers would then either be privy to healthcare savings, or responsible for exorbitant costs.
"So that, we believe, will create the right incentive for those organizations to make sure they're doing the right kind of care, which will ultimately reduce the cost of the Medicaid program," said Dave Richard, DHHS Deputy Secretary of Development Disabilities and Substance Abuse Services.
North Carolina spent $13 billion on Medicaid in 2013. The new program hopes to reduce that cost by about $330 million.
North Carolina spent $13 billion on Medicaid in 2013. The new program hopes to reduce that cost by about $330 million.
But the plan did leave some details for later - like what other incentives there might be to convince providers to join and ACO.
Sen. Louis Pate served on a Medicaid reform advisory board. He says the plan doesn't go far enough to bring costs under control and to offer seamless physical and mental health care for consumers.
The plan now heads to the General Assembly, which will likely review it in May.