DHHS Presents Realistic and Achievable Medicaid Reform Framework

February 26, 2014

Contact: news@dhhs.nc.gov

Raleigh, N.C. - The North Carolina Department of Health and Human Services (DHHS) is currently presenting a framework to reform the N.C. Medicaid program to the Medicaid Reform Advisory Group.
"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:

  • Physical health
    • 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 meeting is being held today from 1-5 p.m. at the State Library/Archives and History Building, 109 East Jones Street, Raleigh. The comments heard 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 ncdhhs.gov/medicaidreform.
For more information, contact Kirsti Clifford, Office of Communications, Department of Health and Human Services, at (919) 855-4840 or kirsti.clifford@dhhs.nc.gov.