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Friday, Aug 21 2015

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In N.C., State Audit Finds Savings From Medicaid Care Management Program

A report from the state auditor shows the program has saved hundreds of millions of dollars over a decade. Meanwhile, North Carolina state legislators continue efforts to reach a compromise on how to reshape the state's health insurance program for low-income people.

A new report from the state auditor shows the program created to manage the care of many of North Carolina鈥檚 Medicaid patients has been successful at saving the state hundreds of millions of dollars over a decade. Between 2003 and 2012, Community Care of North Carolina, or CCNC, saved about $312 annually for each Medicaid recipient, while keeping people out of the hospital. The report also shows CCNC had success in reducing visits for asthma, diabetes and readmissions to the hospital after treatment. (Hoban, 8/21)

The nonprofit program in which primary care physicians keep close tabs on most of North Carolina's Medicaid recipients saves the state more than $300 per patient annually and probably improves their health, according to a state audit released Thursday. The review of Community Care of North Carolina by State Auditor Beth Wood's office, requested by lawmakers in 2013, comes as the organization faces an uncertain future as General Assembly negotiators near agreement on how to overhaul paying to treat Medicaid patients. (Robertson, 8/20)

House and Senate negotiators said Thursday that they鈥檙e nearing a deal to reshape Medicaid and reduce its cost to state taxpayers. The two chambers have been at odds over the future of the government insurance program for the poor, elderly and disabled for more than a year. Both sides want to change the current structure under which doctors, hospitals and other medical professionals are paid for patients鈥 office visits and procedures. Instead, legislators want the state to pay for the program through a flat fee per patient. (Campbell, 8/20)

Tucked into the latest version of a Medicaid reform plan passed by the North Carolina Senate this month is a single line of text that could cost North Carolina billions of dollars. In a section on page three of the 27-page bill, where it describes the bids that companies would have to submit in order to get a contract to manage the care of tens of thousands of Medicaid beneficiaries, is a note that those contracts must provide coverage 鈥渋n all categories except the dual eligible categories.鈥 (Hoban, 8/20)

News outlets also report on developments related to Medicaid and the CHIP program in Iowa, Kansas and Pennsylvania -

The big health insurance companies picked to manage Iowa鈥檚 $4.2 billion Medicaid program have promised to create hundreds of jobs in the state in the coming months, according to bidding documents released Thursday. UnitedHealthcare projected that it would increase its existing 400-employee staff in Iowa by about 250 people. WellCare pledged it would open several offices, from Council Bluffs to Davenport. Amerigroup has already located space for a West Des Moines headquarters. And AmeriHealth Caritas said it would open three 鈥渟tate-of-the-art community wellness centers,鈥 potentially in Des Moines, Cedar Rapids and Sioux City. (Foley, 8/20)

Each month, according to the latest available data, roughly 225 KanCare beneficiaries file complaints about the care they鈥檝e received or been denied. That鈥檚 a small percentage, considering that more than 400,000 Kansans depend on the state鈥檚 privatized Medicaid program. The numbers also show that all but a handful of the complaints are resolved within 15 days. (Ranney, 8/20)

Gov. Wolf announced Thursday a series of small benefit upgrades for families with coverage though the Children's Health Insurance Program (CHIP), effective Dec. 1. Changes include removal of limits on inpatient and outpatient stays for mental-health and substance-abuse treatment, and the end of outpatient co-payments for mental-health services. Vision care was broadened to cover more types of prescription lenses and tinting. (Sapatkin, 8/21)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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