07/16/2024
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McCroryRALEIGH – North Carolina hit another milestone in Medicaid reform Wednesday when Gov. Pat McCrory signed an application that will pave the way for an innovative North Carolina solution. The governor’s proposal will transform Medicaid to provide improved outcomes for patients, communities and providers at a more predictable cost for taxpayers, the governor’s office said in a news release.

“One of the most important responsibilities that I have as governor is to help citizens in our state reach their full potential. To help achieve this goal, reforming Medicaid has been a top priority since the day I entered office,” McCrory said. “Our proposal provides a North Carolina Medicaid Plan that focuses on patient-centered care and improves health outcomes at more predictable costs.”

Health and Human Services Secretary Rick Brajer, legislators, doctors, health care providers, advocates and other partners were on hand for Wednesday’s announcement at the Executive Mansion.

The waiver builds on the Medicaid reform legislation that McCrory signed into law last September. The proposed application will transform health care in North Carolina in six key ways to, the governor’s office said:

Pay for improved patient outcomes – instead of paying for how many services patients receive;

Integrate physical and behavioral health – instead of focusing only on physical health;

Increase flexibility to invest in external factors to improve health – instead of rigidity around payments;

Extend care to families to increase the likelihood of children being reunited with their parents – instead of discontinuing care in families with substance use disorders after their children are placed in foster care;

Encourage providers to achieve the long-term goal of improving health outcomes – instead of limited financial incentives for providers to transform care;

Health plans and providers sharing responsibility with the state for achieving healthy outcomes within budget – instead of only the state facing financial risk.

As part of the reform process, the state’s Medicaid team and partners within the Department of Health and Human Services held a dozen hearings across the state to collect feedback from the public, including health care providers, patients, beneficiaries and advocates. In all, nearly 1,600 people attended the hearings. Additionally, written comments were received from 750 citizens during the public comment period.

By signing the state’s application for the Section 1115 waiver, the governor has put in motion a process that will likely take several years to complete. That process begins with submission of the waiver to the Centers for Medicare and Medicaid Services (CMS). The federal agency is expected to spend at least 18 months reviewing the request. If approved, the following 18 months will be spent bringing the reforms into practice.

Medicaid covers about 1.9 million of North Carolina’s citizens. Those beneficiaries are served by nearly 80,000 health care providers, making North Carolina one of the leading states in health care access for Medicaid beneficiaries.

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