NC Medicaid reform: ACOs dead this year

North Carolina’s Medicaid reform proposal in which Accountable Care Organizations (ACOs) would bear some financial risk for assigned Medicaid populations will not be adopted by the Legislature this year.

Just now in the News and Observer:

Rep. Nelson Dollar, a member of an advisory committee on Medicaid changes, liked the idea of creating Accountable Care Organizations a whole lot more than his Senate counterpart, Louis Pate, did. Pate has said the plan that the state Department of Health and Human Services rolled out in February didn’t go far enough.

Gov. Pat McCrory’s administration wants to change the way the state handles Medicaid by making the budget more predictable and filling gaps in care. DHHS worked on the plan for about a year.

Though he likes the basics, Dollar says not to expect legislation this year that would allow ACOs to be in place by July 2015, as DHHS had posited.

“A direction has been set, there are many more details to be worked out,” Dollar, the chief House budget writer, said this week. “We have made great progress on Medicaid reform. We want to make sure in North Carolina we get it done right and that we have an efficient and effective system serving our citizens for many years to come. It’s far more important that we make sure we get all the detail work right as opposed to setting artificial deadlines.”

In recent years, the legislature has had to scramble to fill Medicaid budget holes. DHHS Secretary Aldona Wos promised the department would do better than it had under previous administrations, (”Cost overruns will not be tolerated and will not be acceptable,” she said at a news conference last year. “There’s a budget for a reason.”) But lawmakers heard last month that there’s another Medicaid shortfall projected at $68 million to $131 million. Legislators who keep an eagle-eye on the Medicaid budget, members of the Joint Legislative Oversight Committee on Health and Human Services, meet again Thursday. 

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