NC seeks input on Medicaid from insurers for reform initiative

November 06, 2017

State health officials are taking another step toward reform of the N.C. Medicaid program, this time addressing requirements for physical managed care organizations.

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In September 2015, the Republican-controlled legislature approved shifting Medicaid from a fee-for-service structure to a managed care structure.

The current Medicaid waiver request to federal health regulators proposes a hybrid public and private sector reform solution that eventually would combine physical and behavioral health into a whole-body care platform.

The N.C. Department of Health and Human Services projects about $400 million in savings in the first five years of implementation.
Last week, DHHS released two requests for information. One addresses physical MCOs, including a statement of interest from prospective prepaid health plans. The deadline for responses is 2 p.m. Nov. 22. The other focuses on the financial aspects of managed care, including information on the proposed capitation rate setting methodology. The deadline for responses is 2 p.m. Dec. 1.
Read the full article here.

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