JLF’s Restrepo testifies before the state’s Medicaid Reform Advisory Group

Becki Gray submits this photo. It shows Katherine Restrepo testifying before North Carolina’s Medicaid Reform Advisory Group.

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Katherine Restrepo has offered recommendations for improving North Carolina’s Medicaid system, including ideas published last spring.

Consumer-driven Medicaid is the “prescription pill” to help battle Medicaid’s current ills, Restrepo said. “Consumer-driven Medicaid emphasizes principles of choice, competition, and fiscal responsibility for beneficiaries and providers,” she said. “Patients may choose from a broad menu of services and products. At the same time, competition arises among insurers and providers. As they embrace the principle of choice, offering consumers whichever enhanced services and benefits they wish, consumer-driven Medicaid turns upside down traditional Medicaid’s uniform list of ‘defined benefits.’”

Patients get access to care through “defined contributions,” or block grants distributed by a fixed state fund. “When money is placed in the hands of a patient, it is more likely to be spent wisely, especially when patients must pay for certain health services out-of-pocket. This encourages fiscal responsibility.”

Restrepo also highlights the important role of managed care organizations in overseeing Medicaid benefits. “If properly run, MCOs allow their contracted networks of providers to offer quality preventative health services to patients, yielding positive health outcomes and cost-effectiveness.”

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