NC Medicaid Choice is a coalition formed in support of reforms that modernize North Carolina’s Medicaid program. The Coalition supports systematic changes that deliver budget predictability and better health outcomes for Medicaid recipients.
NC Medicaid Choice will work with North Carolina lawmakers to develop legislation that shifts financial risk of the state’s Medicaid program away from taxpayers. We support an approach that allows traditional managed care plans and those offered by health care providers to compete in North Carolina’s Medicaid market. This collaborative approach would better control costs while improving patient outcomes.
North Carolina’s Medicaid program cost $13.3 billion last year, of which $3.4 billion was paid by North Carolina taxpayers. Despite the state’s large investment in Medicaid, North Carolina taxpayers still aren’t getting the value they deserve. Annual shortfalls in the state’s Medicaid program have averaged nearly $350 million over the past five years. Medicaid shortfalls and growing costs threaten funding for other important budget priorities such as education.
Our coalition encourages state lawmakers to adopt a reform plan similar to those already working in other states that allow Medicaid recipients choice. Competition among plans would drive health care innovations that improve the quality of care and health outcomes.
Currently, our state is one of the few that still relies on a fee-for-service Medicaid system that pays doctors primarily for the volume of service they provide rather than for quality care and patient outcomes. Currently, 39 states have adopted Medicaid reforms that shift financial risk from taxpayers to organizations that are paid a fixed fee set by the state to support the health care needs of Medicaid recipients.
While our state has made progress toward better care coordination through Community Care of North Carolina, a competitive model shifts financial risk away from the state and is the logical next step.
NC Medicaid Choice members include: Aetna, Amerigroup, AmeriHealth Caritas, UnitedHealth Group and WellCare.