The Stanly News and Press (Albemarle, NC)

Opinion & Letters to the Editor

March 6, 2014

New Medicaid path put into place by Gov.

Tuesday, March 4, 2014 — RALEIGH – A month ago, I wrote that Gov. Pat McCrory and his top health official, Health and Human Services Secretary Aldona Wos, might finally be setting the stage for a political and policy victory.

This week, the stage was indeed set. Now we get to see whether the McCrory administration can finish the deal.

That view of what occurred this week regarding the multi-billion dollar Medicaid program may not be universally shared.

For months, McCrory, Wos and other state health care officials had been discussing handing over all or portions of Medicaid to manage care entities, essentially insurers, who would bid on the state’s business on a per-patient cost basis.

Theoretically, the bidding process, and the desire of the insurers to make money, would save money and bring more cost certainty to the Medicaid program.

That result hasn’t always occurred in other states that have turned to managed care models for Medicaid. Sometimes those insurers have cherry-picked the healthy Medicaid populations; other times they have left when their contracts didn’t generate expected profits.

What would have happened in North Carolina is only conjecture.

That’s because the McCrory administration ultimately listened to hospitals, doctors and other medical providers who see managed care as a bad idea.

Their pocketbooks play a role in their disapproval. But they also argue that managed care would mean putting Medicaid patients in the middle of fights between insurers and doctors, with patient care ultimately suffering.

What McCrory and Wos embraced instead is a system that utilizes something called accountable care organizations (ACO) to try to control costs.

The ACOs are networks of health care providers, who act together to try to create seamless care for patients but in a fee-for-service system as currently exists. Doctors and others in the network receive financial incentives or penalties based on their ability to keep patients healthy and out of high-cost treatments.

Critics of the ACOs say they encourage more consolidation of health care providers.

That criticism is what ignores the consolidation that is already occurring. Big regional hospitals and their networks have been dominating the health care market regardless of any Medicaid changes.

Policymakers who try to stem that tide are probably fighting a losing battle.

By pursing the ACO path, McCrory can achieve a victory while creating at least some of the cost savings and certainty that he hopes for.

That the chief budget writer in the state House, Wake County Republican Rep. Nelson Dollar, appears to embrace the idea may signal that part of the political battle – getting the House to go along –- can be won.

The Senate may be a different matter.

But politics, no matter who is in charge, typically comes down to compromise. This development has the feel of compromise that may benefit taxpayers and Medicaid patients.

And the alternative may be the current system that eats away growing chunks of the state budget.

Scott Mooneyham is a syndicated columnist for Capitol Press Association and covers activities of the N.C. Legislature.

Text Only
Opinion & Letters to the Editor
  • Doug Creamer Maintaining hope

    Gardeners are facing challenges with the weather this year. It seemed like we were getting great conditions in April and May. The weather was warm and we were getting some good rains. Then sometime in June the rain stopped. It got so dry that I didn’t have to cut the grass. While I enjoyed the break, the garden was not happy at all. I was having to water quite a bit to keep the vegetable garden alive and growing.

    July 22, 2014 1 Photo

  • Jason O. Boyd I may be a bit behind the times, but at least I can find ‘America’

    I seem to be reading about and dealing with technology a lot lately.
    I  love technology and have always been fascinated by gadgets of all kinds and the wonderful things they can do. You never seem to go through an entire day without some form of invention enhancing your life.

    July 21, 2014 1 Photo

  • Brent Laurenz Meeting out in open helps negotiations move ahead

    RALEIGH – State lawmakers reconvened in Raleigh on May 14 promising a brief legislative session this summer, but as July moves along they are still in town and tackling big issues.

    July 21, 2014 1 Photo

  • Larry's Sketch 7.16.14.tif They don’t give a darn for Duke University

    John “Duke” Wayne’s heirs are suing Duke University over trademark rights.

    July 21, 2014 1 Photo

  • Your chocolate addiction is only going to get more expensive

    WASHINGTON - For nearly two years, cocoa prices have been on the rise. Finally, that's affecting the price you pay for a bar of chocolate - and there's reason to believe it's only the beginning.

    July 18, 2014

  • Patrick Gannon Don’t forget the losers in state lottery

    RALEIGH – Behind every state lottery dollar that goes to education is a loser.
    There’s also a winner – the teacher whose salary it pays, the student who gets a scholarship or the district where a new school gets built. But we hear about the winners in advertisements and in press releases.
    This column is about the losers.

    July 18, 2014 1 Photo

  • Hodgepodge Cooling an overheated hedgehog and other summer travel stories

    Anybody with a pet during the summer inevitably finds themselves facing this question: What do I do with my pet on vacation?
    There are kennels for dogs, day cares for cats. Shoot, you can even find a friend to take care of your guinea pig.
    But what do you do with a hedgehog?

    July 18, 2014 2 Photos

  • North Carolina Boasts Top Wildlife Magazine and A Success Story

    The following opinion piece was released by the N.C. Wildlife Resources Commission:

    RALEIGH  — When Wildlife in North Carolina, the magazine published by the N.C. Wildlife Resources Commission, was named recently as the nation’s best in its category, it reflected more than accolades as a quality publication.

    July 17, 2014

  • 130408_NT_BEA_good kids We're raising a generation of timid kids

    CHICAGO - A week ago, a woman was charged with leaving her child in the car while she went into a store. Her 11-year-old child. This week, a woman was arrested for allowing her 9-year-old daughter to go to the park alone. Which raises just one question: America, what the heck is wrong with you?

    July 17, 2014 1 Photo

  • 25 hidden secrets in "Weird Al's" "Word Crimes" video

    Yankovic's 14th album was released this week, and it warms my heart containers that he's kept up his geeky brand of humor for so long. While he has written so many incredible songs, none have spoken to my love of proper grammar.
    Until "Word Crimes."

    July 16, 2014

House Ads
Seasonal Content