Gov. Pat McCrory and leaders of North Carolina physician organizations tried Wednesday to get the governor’s Medicaid overhaul plan back in front of the legislature after the state Senate essentially rejected his idea.
Standing next to more than 30 doctors in their traditional white coats, McCrory said the proposal developed by his administration is the best way to bring budget predictability to Medicaid and improve patient care.
“We cannot wait any longer to begin steps to reform our Medicaid system in North Carolina,” McCrory said outside the Executive Mansion, where inside he had earlier hosted about 150 medical professionals to discuss his plan.
Doctors and hospital groups back the idea of “accountable care organizations” developed after months of meetings by an advisory board. Hospital and doctor networks would share in Medicaid savings and cost overruns. Patient health and administrative efficiencies also would play roles in calculating the organization’s windfalls or payments.
Senate Republicans don’t believe the organizations will generate enough savings for the state and would fail to apply to other medical treatments, such as mental health coverage.
The Senate budget directs the Department of Health and Human Services to stop working on the model and start over. It also said Medicaid ultimately will be removed from the agency.
A key senator on health issues said it was possible the final product could mean an outside managed care organization would oversee Medicaid, which serves 1.8 million people and spends $13 billion in state and federal funds. Medical trade groups say that kind of model could harm patients with less care in the name of improving profits.
“For the life of me I cannot understand why anyone would want to destroy all this good work and start over with a managed care approach that’s been tried and failed in so many places,” said Dr. Bill Dennis of Henderson, president of the North Carolina Academy of Family Physicians.
The House is developing its budget, which is still slated to be voted on by the end of next week. Republicans in the chamber have been more open to McCrory’s idea but have cautioned against approving any dramatic Medicaid change this year.
The accountable care organizations are expected to generate savings equal to 3 percent of the Medicaid budget when fully implemented, the agency estimates. But McCrory said “right now we don’t have any savings.”
Earlier Wednesday, about 20 people seeking to expand Medicaid to more of the working poor under the federal health care overhaul gathered outside the Legislative Building. They planned to deliver a petition to House Speaker Thom Tillis, R-Huntersville, which they say contained the names of 25,000 people seeking the expansion.
The General Assembly and McCrory passed a law last year preventing the expansion, saying at the time that Medicaid wasn’t prepared to handle hundreds of thousands of additional patients. They also said they couldn’t trust the federal government to keep paying the overwhelming share of the costs over time.
Belhaven’s Pungo Hospital, which serves many low-income residents in far Eastern North Carolina, is facing closure. Belhaven Mayor Adam O’Neal said an influx of Medicaid dollars could help prevent the closure.
“Hospitals in rural North Carolina struggle anyway,” O’Neal said, adding that “instead of getting extra revenues, which would make local hospitals stronger, we’re actually getting less revenues than before, and making them weaker.”