02/19/2019
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Volatility at local level, Medicaid funding future uncertain

By Erin Smith

The Eastpointe Board of Directors met Tuesday and heard a presentation regarding the future of Medicaid. The board also installed a new Board of Directors Chairman and Vice-Chairman.

Cardinal Innovation Healthcare CEO Richard Topping made a presentation to the Eastpointe Board of Directors sharing information about the future of healthcare and specifically about the future state of Medicaid. He began his remarks by saying there is volatility at the local level when it comes to providing  mental health services. Topping said, “Folks are not necessarily getting services where they need them, when they need them.”

Topping said that as of last year, legislation was in place that set July 1, 2019 as the deadline to phase in integrative care and create a standardized Medicaid market in 2019. Topping said currently, there has been a collapse of the Medicaid reform bill and there are now divergent views on Medicaid. This has created some volatility within the system.

Topping told the Eastpointe Board that basically, this means there will be the need to continue to use fund balances to cover services, there is no transition plan in place to move the system towards integrative care, and there is no time frame for the transition to integrative care to take place. He added the North Carolina General Assembly does have special sessions coming up and the situation potentially can change based on any actions the General Assembly may take on Medicaid during those sessions.

Topping told the board the U.S. Senate had voted to move forward with debate over its proposed repeal and replace bill for the Affordable Care Act. Topping said there were a few options the Senate could act on. He explained there is a “skinny appeal” which means the Senate could repeal the mandated items only and leave the rest of the Affordable Care Act in place; the Senate could adopt the 2015 Repeal and Replace Bill which Sen. Rand Paul supported; or the Senate could adopt the proposed Better Care Reconciliation Act of 2017. He emphasized to the board that currently there is no clarity where federal Medicaid policy is concerned.

Topping said in the future there is going to be less money in the Medicaid system. He said more people will need more care and there will be less money available to provide that care. He said the Medicaid expansion is now impacting state governments. Topping said states that accepted the Medicaid expansion already cannot afford the expanded Medicaid system. He said North Carolina was not a Medicaid expansion state.

Topping also noted that there is proposed tax reform legislation also being discussed and, depending on the action taken by the legislature, this too can impact the system.

Topping was asked by Eastpointe CEO Sarah Stroud how this may impact the future of LMEs/MCOs and Topping replied it depends on who one is speaking with as to what the future MCOs/LMEs may look like. Topping said the focus needs to remain on the continuity of care.  “Volatility is at the local level,” said Topping. He said the goal is going to continue to be to provide continuity of care for patients.

In other business, the board conducted a closed session to discuss litigation and matters of client-attorney privilege.

The board also named J. W. Simmons of Sampson County as the new board Chairman and Jerry Stephens of Robeson County was named as the new Vice-Chairman. These are two year terms.

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