Nonprofits at the Table: Medicaid Transformation

There are many changes emerging within North Carolina’s healthcare systems, chief among them, Medicaid transformation and the transition to value-based care.

As a key stakeholder that educates, connects, and advocates for nonprofits, the North Carolina Center for Nonprofits is embarking on a major year-long project to provide education programs regarding Medicaid transformation and its impact on our state’s nonprofits.  With the generous support of the Kate B. Reynolds Charitable Trust and Blue Cross and Blue Shield of North Carolina Foundation, the Center is honored to lead this educational effort. 

Project support provided by

Blue Cross Blue Shield and Kate B. Reynolds Foundations


Medicaid – Say What?

Two terms – Medicaid transformation and Medicaid expansion – are being bantered around a lot these days. Though related, they’re different.

  • Medicaid transformation is the ongoing switch to a privatized managed care system from North Carolina’s current fee-for-service model, where the state pays for every doctor visit and hospital stay for the 2.1 million low-income North Carolina seniors, disabled persons, children and their mothers already on the federal safety net program. In the new managed care system, the state will pay preselected managed care companies a per-person rate to handle all of an individual’s health care needs.

  • Medicaid expansion is an outgrowth of the Obama administration’s Affordable Care Act and would use mostly federal dollars to extend Medicaid coverage to low-income adults currently unable to afford to buy their own health insurance on the open marketplace. North Carolina is one of 14 states, mostly in the Southeast, who have not expanded Medicaid.

Source: North Carolina Health News, a sidebar within a 9/4/19 article by Sarah Ovaska-Few


Education Program Highlights

Statewide Survey:  Assessing Nonprofits’ Preparedness for Medicaid Transformation 

The Center invites nonprofits to help it learn by sharing their own practices, experiences, capacities, and knowledge about changes to value-based care.  The survey will open October 4 – October 18, 2019. Results will help the Center and its funding partners plan and recommend future professional development opportunities to help nonprofits navigate Medicaid transformation.

If you are interested in Medicaid Transformation and wish to share your experience and understanding of the topic, click here to take the survey.


Listening and Learning Tour

The Center will host invitation-only focus groups held in November in each region of the state to have a conversation about what nonprofits know, don’t know, need and want related to Medicaid transformation. Results will help the Center and its funding partners plan and recommend future professional development opportunities to help nonprofits navigate Medicaid transformation.


Workshops

Held in spring 2020, the Center will present five day long workshops held around the state for health and human services nonprofits that will be impacted by Medicaid transformation.

These workshops will be designed to: 

  1. Inform stakeholders on Medicaid transformation efforts in North Carolina; 
  2. Translate how state policy reform efforts can present potential opportunities and challenges for NC nonprofits; and
  3. Foster collaboration and engagement between different types of nonprofits in each community.  

Content and instructors provided by the Center for Health Care Strategies. Dates and registration information announced by late October 2019.


Webinar

Held in spring 2020, this webinar is for anyone interested in Medicaid Transformation, valued-based care, and its impact on health service organizations in North Carolina.  Content and instructors provided by the Center for Health Care Strategies. Date and registration information announced by late October 2019.


Resources

Explore these resources to learn more about Medicaid transformation:

  • Medicaid Transformation, NC Department of Health and Human Services (NC DHHS).  Overview about transition to Medicaid managed care in 2020 – the most significant change to the NC Medicaid program in over 40 years.
  • “Provider Transition to Medicaid Managed Care 101,” NC DHHS, March 2019.  Overview of Medicaid transformation vision, and context, plus managed care definitions and system descriptions.   
  •  Healthy Opportunities. Description of NC DHHS’s initiative.  Includes links to information about Healthy Opportunity Pilots, NCCARES360, policy papers, and NC maps showing social determinants of health indicators. 
  • “Healthy Opportunity Pilots” (slide deck), presented by Elizabeth Cuervo Tilson, MD, MPH, State Health Director/Chief Medical Officer, NC DHHS, September 2019.