Community Care of North Carolina saves the state’s Medicaid program money, by about $309 per patient, according to an audit released today by the State Auditor’ s Office.
The audit was conducted at the behest of the legislature, which asked for it in 2013 to see if the state was saving money by using CCNC, a provider-led entity that manages the health care of approximately 1.2 million of the state’s 1.5 million Medicaid recipients. Medicaid is a federally-mandated program that provides health care to low-income children, elderly and disabled people.
North Carolina lawmakers have opted not to expand Medicaid, which would offer health insurance to additional low-income adults not eligible for health insurance subsidies on the open market.
The State Auditor’s office, headed by Democrat Beth Wood, contracted with an outside medical research $279,457 to conduct the audit. Major findings included the $309 annual savings per patient (based on 2003 to 2012 data), as well as what were seen as improved health outcomes, a 20 percent increase in physician’s services (which is believed to prevent more expensive future care) and a 25 percent drop in inpatient admissions. The researcher saw no statistical difference in emergency room visits.
Click here to read the entire audit.
CCNC works by pairing Medicaid patients with a primary care doctor or office, which for an additional fee then helps manage individual patient’s care with the intention of cutting down on unneeded medical expenses and providing better care.
CCNC’s future in the state is murky, with the Republican-led House and Senate chambers currently trying to decide how the $14 billion Medicaid program should be managed, and whether it should be privatized. House members have been more open to keeping CCNC, while the Senate has proposed doing away with the state’s contract with CCNC and instead turning to managed-care health companies to take over the bulk of the state’s Medicaid cases.
There’s also been considerable turnover in CCNC itself. Several top leaders left the non-profit entity recently, for what CCNC described as a “downsizing.”