Doctors, rather than out-of-state corporations, should take the lead in carrying out Medicaid reform in North Carolina, a state medical care commission reported recently.
The General Assembly is looking at ways to rein in costs for covering low-income children, parents and disabled adults. Two proposals are on the table: One of which relies on accountable care organizations run by physicians (ACOs) and another that allows for-profit managed care organizations (MCOs) to compete.
The bipartisan N.C. Medical Care Commission, with members appointed by current Republican Gov. Pat McCrory and earlier Democratic governors, sided with the first approach. Members include Charlotte dentist Paul McGill and Mary Piepenbring, vice president for health care of the Charlotte-based Duke Endowment.
“The Commission has confidence in the current providers in North Carolina to fulfill this mission,” the group wrote. “ ... (W)e believe we have within our State the ability to provide home grown solutions to best serve our citizens. North Carolina currently has over 20 active Accountable Care Organizations (ACOs) in addition to the nationally acclaimed Community Care of North Carolina, five medical schools, and no fewer than 10 regional hospital systems ready to take on this task.”
Dr. Jeffrey Runge of the N.C. Medical Society told the medical panel that channeling Medicaid money to physician-led groups lets the money go “to care of the patient, not to corporate stockholders.” The medical society is urging the state to start with rewards for cutting cost and improving care, while holding off on the per-patient payments that would penalize doctors if costs run over budget. (See Runge’s presentation here.)
Meanwhile, a coalition of managed-care companies has also launched a group called N.C. Medicaid Choice to push for the bill that would let them jump in, arguing that their participation would lead to bigger savings and a quicker roll-out.