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Veteran physician: Improve public Medicaid system; don’t sell it to private HMO’s

Medicaid [1]As Governor McCrory and his HHS Secretary Aldona Wos convene a rather strange closed door “listening  session” on Medicaid in Greensboro today (it’s scheduled to last all of 45 minutes), let’s hope they both took the time over the weekend to read an excellent, “from-the-trenches” essay by Goldsboro physician Dr. David Tayloe in Raleigh’s [2]News & Observer [2]In it, Tayloe explains the importance of preserving and improving North Carolina’s homegrown “medical home” model for delivering Medicaid services (Community Care of North Carolina) rather than falling for the false promises of out-of-state HMO companies that have been trying to muscle their way into the state.

CCNC is rooted in care coordinated by providers, not insurance corporations. By keeping care decisions in the hands of those most qualified to make them, medical home models improve health outcomes for North Carolina’s Medicaid population. Doctors, care managers and pharmacists across provider-led networks share data and best practices to provide efficient and high-quality care to patients, decreasing emergency room visits and reducing wasteful spending.

The CCNC model is the result of decades of work that has consistently generated positive results in North Carolina. An HMO takeover of this system would mean higher administrative costs to the state and billions of taxpayer dollars leaving the state to pay corporate shareholders. Under federal Medicaid rules, the additional money required to pay HMOs can come from only one place – sharp cuts to provider payments. When physicians choose not to participate in Medicaid, patients neglect preventive care and head to the emergency room in crisis, raising state costs while producing less positive health outcomes.

As president of the American Academy of Pediatrics (2008-2009), I had the opportunity to discuss Medicaid with pediatricians all over the country. It became obvious that CCNC is the best model available for taking good care of Medicaid patients. It concerns me that our state would scuttle a proven care model in return for a for-profit system that primarily benefits special interests outside the state.

I would hope that our leaders would go forward with cost-saving initiatives that assure CCNC will continue to provide cost-effective, high-quality care for patients who rely on Medicaid in our state. If North Carolina moves to an HMO model, doctors will leave the program, patients will have less access to care and a primary care infrastructure that is the envy of other states will be lost.

Read Dr. Tayloe’s entire op-ed by clicking here [2].