State health officials tout Medicaid planning

May. 15, 2013 @ 11:42 PM

Two key N.C. Department of Health and Human Services officials on Wednesday soft-pedaled the likelihood that out-of-state companies will secure the lion’s share of the work when the state reorganizes the management of its Medicaid program.

“That has been the biggest myth of what we’ve talked about,” state Medicaid boss Carol Steckel told a group of health care professionals who gathered in Durham to ask her and health Secretary Aldona Wos about the state’s plan.

Wos added that the department is “100 percent committed” to the management model it’s developed over the past decade or so in cooperation with a nonprofit, Community Care of North Carolina.

The group has orchestrated local-level care networks that serve about 1 million Medicaid recipients.

But Wos also told those attending Wednesday’s conference that it’s “probably not wise to have one of anything,” as that conflicts with patient choice.

That comment, offered at the start of the meeting, alluded to the proposal she and Gov. Pat McCrory have floated that calls for divvying up management amongst three or four “comprehensive care entities” chosen from the public or private sectors.

The apparent contradictions drew immediate notice from critics of the governor’s proposal and other observers.

Don Taylor, a public policy professor at Duke University, tweeted afterwards that Wos had “trouble answering questions about the [governor’s] blueprint in a way that is consistent with her own slides.”

Taylor worries that private-sector bidders – managed-care organizations, possibly –will shy away from serving Medicaid recipients with complex or acute health problems. They have every incentive to cherry-pick the healthiest patients, he said in a blog post earlier this month.

Wos addressed the managed-care possibility on Wednesday, telling those present that, in her experience as a physician, such systems weren’t all that successful.

Since doctors and hospitals abandoned straight fee-for-service dealings with patients, they’ve accumulated “at least 30 years of experience of what can possibly work, what maybe works, what kind of works and what really doesn’t work,” she said.

She added that department leaders “certainly never want to repeat the mistakes of the past that any other state has made.”

The goal of the initiative, she said, is to “have North Carolina be the best place in the United States for physicians and health care providers to come to, to relocate [to] and to work.”

That tied in with an earlier comment by her that the state seems to have an overall shortage of health care professionals.

Wos and Steckel several times said they want to cut down on the paperwork physicians and medical practices have to deal with, and make it easier for patients to obtain care across medical disciplines.