October 29, 2020
Medicaid is foundational to our social safety net. It plays an integral role in our healthcare system as the primary payer for long-term care and covers more than half of the births in North Carolina. Changing such a significant program has major implications for everyone – not just those covered by the program or healthcare providers. Everyone needs to understand how North Carolina’s Medicaid program will change in the coming months and what it means for them.
Healthcare providers in North Carolina face a steep learning curve to adapt to Medicaid Transformation.
Experience tells us that no matter how well-designed and planned a Medicaid transformation is, the first year of a new managed care program is fraught with challenges. As a result, most state Medicaid programs experience a reduction in their provider and CBO participants as smaller, less sophisticated organizations cannot quickly adapt.
However, those Medicaid stakeholders that understand — the rationale and goals for the changes (why), the policies and initiatives that will be set to regulate and guide the changes (what), and the operational changes that will be implemented (how) — can prepare for those challenges and often rise to the top of their service industry.
The panel includes North Carolina’s Department of Health and Human Services officials and experts from the Atrómitos team that have worked in Medicaid-managed care markets across the country with providers, state agencies, CBOs, and other integral stakeholders.