Gov. McCrory's medicaid proposal to be reviewed

Gov. Pat McCrory’s recent announcement of proposed changes to the state’s Medicaid program has elicited mixed reviews from members of the UNC health care community.

Earlier this month, McCrory announced his plan to alter the state’s Medicaid program, entitled “Partnership for a Healthy North Carolina.”

McCrory’s proposal would shift Medicaid to a system where several public or private entities would be awarded contracts to manage health care services.

Health care providers would be paid based on a per-member, per-month plan, where they are given a set amount of money to spend per patient.

They would also have to absorb any extra costs, which is meant to encourage affordability.

“The key issue for Medicaid right now is being more efficient and being more effective,” said Julie Henry, spokeswoman for the N.C. Department of Health and Human Services.

Henry said one in five state residents uses Medicaid, a program that costs $13 billion annually and spends $36 million a day.

“One of the cornerstones of this framework is really to try to bring that care together so that individuals are being looked at as a whole person,” Henry said.

“The other piece is creating a system that is community-focused and builds on innovations that North Carolina has been recognized for.”

Dr. Bill Roper, CEO of the UNC Health Care System, said in a statement that he supported McCrory’s willingness to re-evaluate Medicaid.

“I look forward to working with them and other hospitals on this important endeavor to better serve North Carolina’s patients and determine the best solution for Medicaid,” Roper said.

But Donna Parker, spokeswoman for the UNC Department of Family Medicine, said there is uncertainty about how the proposal would change its operations.

“We are watching to see what happens,” she said. “None of us are exactly sure how it will impact us, but we know it will impact us.”

Jonathan Oberlander, UNC professor of social medicine, said the push to change Medicaid is not based on a need to fix the program, but rather on ideology.

“The reforms reflect a commitment by the McCrory administration and Republicans in the legislature to remake Medicaid in a way that fits their principles and political commitments,” he said.

“They are interested in expanding the role of private insurers. I’m not sure anything that has happened necessitates restructuring.”

Oberlander said similar programs in other states did not necessarily lower costs.

“The evidence is that it doesn’t produce a lot of savings,” he said. “Quality of care depends on what kind of health care you get.”

Henry said the Department of Health and Human Services will try to learn from other states.

“We want to do it differently,” she said. “We want to do it right.”

Contact the desk editor at state@dailytarheel.com.