North Carolina’s nascent Medicaid reform VII: new advisory panel
August 5, 2013 3 Comments
This is the seventh post in a series on North Carolina’s nascent Medicaid reform, Partnership for a Healthy North Carolina, a reform option being pursued even as North Carolina does not proceed with the Medicaid expansion available in the ACA.
- First post: Logic of the N.C. plan
- Second post: Who is covered by Medicaid?
- Third post: Medicare Advantage as a Model?
- Fourth post: Who are the dual eligibles?
- Fifth post: What N.C. organizations could be an entity?
- Sixth post: Three insurers will offer plans in ACA exchange (impact on Medicaid reform)
I am skeptical of the plan, but am granting the benefit of the doubt and trying to work through some key issues and asking questions about it in the hopes of helping to move Medicaid reform ahead. The posts in this series are marked with the tag NC Medicaid Plan.
Dan Way has a post on the Medicaid Reform Advisory Board that was created by the passage of the North Carolina Budget in July, 2013, that is to put the meat on the bones of North Carolina’s nascent Medicaid reform approach, Partnership for a Healthy North Carolina. As the above linked 6 posts show, I have lots of questions and doubts about the outline of the plan as I understand it, but it remains quite vague and this 5 person advisory board appears to be the next step toward clarity which is a good thing. Several points about this committee (created by sec SECTION 12H.1.(e) of the budget, p. 162):
- At 5 members, it is lots smaller than the mid-June proposed 22 member panel from the House deliberations. All else equal, a smaller panel is more likely to develop a recommendation to move toward action than is a larger board. 2 of the 5 members are to be members of the General Assembly who are appointed (one each) by the Speaker of the House, and the Leader of the Senate, while the Governor appoints the other 3 members. Any recommendation proposed by this Board can be made law during the short session in May-June 2014. All signs point to this Board being a step toward action.
- Recommendations are due to be submitted to the General Assembly for legislative approval no later than March 17, 2014.
- Three broad charges are provided to the committee: (1) stability and predictability in budgeting; (2) making it easier for providers to use the system; and (3) integrating physical and behavioral health care for patients.
- There are a variety of other items this committee will undertake, including $100,000 provided to the State auditor to undertake an evaluation of Community Care North Carolina (CCNC).
There are quite a few mistakes in the post, or at a minimum, ways of interpreting the past experience of Medicaid (and some are quotes of others, in fairness to the blog poster) that are not how I would put things. However, I am going to let these pass and not comment on them at this time, because the formation of this committee is the start of the Republican majority in North Carolina moving beyond only talking about the problems with the system they say they inherited, and toward them committing to the details of what they are for in Medicaid reform. And that is a good thing.
update: I revised for clarity