JLF Research | Policy Reports

The Partnership for a Healthy North Carolina: Medicaid Reform that Works for Patients, Providers, and Taxpayers Alike

Katherine Restrepo
May. 29th, 2013
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North Carolina’s most vulnerable Medicaid patients deserve a health care safety net that meets their needs and moves them from sickness to health. North Carolina taxpayers deserve peace of mind their sacrifices to fund that safety net are not being squandered on a failing program that cannot meet its purpose. And North Carolina policymakers deserve budget certainty when it comes to Medicaid spending, so they can adequately fund the program and all other state priorities.
North Carolina’s current Medicaid program does not meet a single one of these objectives:
In 55 percent of the most widely-tracked patient health outcome measures, North Carolina scored worse in 2011 than it did in 2010.
Total Medicaid spending in North Carolina has grown almost 90 percent in the last decade, from less than $8 billion annually just a decade ago to more than $14 billion annually in 2012.
North Carolina spends more per-person on Medicaid than any of its seven state neighbors, as well as the U.S. average.
In each of the last four fiscal years, North Carolina’s Medicaid spending exceeded its appropriated budget by an average of 11 percent.
Recognizing North Carolina’s Medicaid failures, Governor Pat McCrory has proposed the Partnership for a Healthy North Carolina, an innovative reform to redesign North Carolina Medicaid into a truly pro-patient, pro-taxpayer health care safety net.
The Partnership for a Healthy North Carolina infuses the Medicaid program with winning market-based strategies of competition, accountability, transparency and a common-sense funding structure. Key features of the plan include:
Patient choice – patients can choose from among several competing private plans to find one that will serve them best.
Smarter funding – plans receive a fixed amount of funding per patient—with sicker patients garnering greater funding—and receive additional compensation if they succeed in improving patients’ health and quality of life. Funding is truly aligned with patient health.
Streamlined reimbursements – consolidated payment systems ensure health care providers are reimbursed more quickly for the treatments they provide.
Taxpayer savings – the patient-centered reforms are expected to save the state upwards of 8 percent per year—an annual savings of more than $1 billion.
Although North Carolina policymakers should explore additional ways to make the Governor’s proposal even stronger, the Partnership for a Healthy North Carolina represents a major step forward in transforming Medicaid into an affordable and successful health care safety net.

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Policy Report The Partnership for a Healthy North Carolina: Medicaid Reform that Works for Patients, Provid...

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