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
  • Brent Laurenz Special election adds to the mix

    RALEIGH – A busy slate of judicial elections this November got even busier recently when Judge John Martin of the N.C. Court of Appeals announced his retirement.
    A special statewide election to fill Martin’s seat will be added to the general election ballot, joining the four N.C. Supreme Court seats and three N.C. Court of Appeals races already slated for this fall.

    July 25, 2014 1 Photo

  • Patrick Gannon Fake news or sign of some more trouble?

    RALEIGH – Of the three situations I can recall where agencies receiving large sums of taxpayer dollars wouldn’t divulge employees’ salaries, two of them ended badly. The third – involving a group of charter schools in Southeastern North Carolina – is playing out right now.

    July 25, 2014 1 Photo

  • Almost half of America's obese youth don't know they're obese

    WASHINGTON - The good news is that after decades of furious growth, obesity rates finally seem to be leveling off in the U.S.. The bad news is that America's youth still appear to be dangerously unaware of the problem.

    July 23, 2014

  • Darth Vader is polling higher than all potential 2016 presidential candidates

    On the other hand, with a net favorability of -8, Jar Jar is considerably more popular than the U.S. Congress, which currently enjoys a net favorability rating of -65.

    July 23, 2014

  • D.G. Martin Where did all these new voters in North Carolina come from?

    “Voters born elsewhere make up nearly half of N.C. electorate.”
    So begins the latest DataNet report from the UNC Program on Public Life, directed by former journalist Ferrel Guillory.

    July 23, 2014 1 Photo

  • Patrick Gannon Some light for Dems in their time of darkness

    RALEIGH – Earlier this year, state Sen. Ben Clark, a Hoke County Democrat, became a hero for a day among his party and environmentalists when his amendment to require more well water testing near future fracking sites passed the Senate. It even gained the support of a number of GOP senators, against the wishes of the Republican bill sponsor.

    July 23, 2014 1 Photo

  • mama.jpg What we get wrong about millennials living at home

    If the media is to be believed, America is facing a major crisis. "Kids," some age 25, 26, or even 30 years old, are living out of their childhood bedrooms and basements at alarmingly high numbers. The hand-wringing overlooks one problem: It's all overblown.

    July 22, 2014 1 Photo

  • 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

House Ads
Seasonal Content