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MedicaidAs 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 News & ObserverIn 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. Read More

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Health-Reform-SBAs Adam Linker explained last week when he debunked the latest conservative mythology surrounding the Affordable Care Act, the law continues to succeed despite its imperfections and the endless, hysterical attacks of the President’s political opponents.

Today, there’s still more confirmation of this undeniable reality from Washington state. As The Olympian reported this morning, the state’s uninsured rate has been plummeting:

State insurance officials say fewer than 9 percent of Washington residents still don’t have health insurance.

That’s a significant improvement from numbers before the Affordable Care Act went into effect.

The state Office of the Insurance Commissioner counted 970,000 uninsured Washington residents last year. That number is now 600,000 or about 8.65 percent of the state population.

Agency spokeswoman Stephanie Marquis told The Olympian (http://is.gd/p2XsBG ) two factors are driving the improvement: enrollment in Medicaid and sign-ups for private insurance, but inside and outside of the new state health insurance exchange.

The insurance department reports the individual market has grown to more than 327,000 policies. That represents about 81,000 more insured people than before Oct. 1, when Washington’s Health Benefit Exchange opened.

The exchange also helped sign up nearly 350,000 people for free insurance through Medicaid.

Despite the many successes here, at last check, North Carolina’s uninsured rate remains significantly higher.

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In a new post this afternoon, Jesse Cross-Call at the Center on Budget and Policy Priorities reports the latest confirmation that North Carolina is shooting itself in the foot with its stubborn and shortsighted refusal to expand Medicaid to hundreds of thousands of uninsured people under the Affordable Care Act.

As a growing number of reports increasingly make clear, a state’s decision whether to expand Medicaid as part of health reform has real-life effects on its residents and its businesses.  In the 26 states and the District of Columbia that have expanded Medicaid (see map), the positive benefits are already playing out.  Here’s some of the latest information:

  • Hospitals are providing less uncompensated care.  In Arizona, hospitals reported that the Medicaid expansion is the chief reason for a 30 percent decline in the amount of uncompensated care they have provided so far this year, compared with a year ago.  The Colorado Hospital Association found a similar decline in charity care through April when it surveyed hospitals in 15 states that have expanded Medicaid and 15 that have not.
  • Medicaid expansion is driving large gains in health coverage.  A survey conducted by the Urban Institute finds that while the uninsurance rate is dropping across the country, states that have expanded Medicaid have seen a drop in the percentage of non-elderly adults who are uninsured by more than one-third — a 37.7 decline — while the uninsured rate fell by only 9 percent among states that haven’t expanded.  A survey from the Commonwealth Fund found a similar trend. Read More
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MedicaidThere’s new and compelling evidence that North Carolina’s model for delivering Medicaid (Community Care North Carolina -CCNC) is a winner — notwithstanding the often-bumbling oversight provided by embattled state DHHS Secretary Aldona Wos and the attempt by Senate leaders to sell the program off to a private managed care company. (It’s worth noting that the flawed sell-off idea was once also touted by Gov. McCrory and Sec. Wos as well until the two gradually came to their senses over the past year).

Today, in a letter to state Medicaid directors throughout the country, the Centers for Medicare and Medicaid Services at the national DHHS announced today that they are launching a new national collaborative initiative called the “Medicaid Innovation Accleerator Program.” The goal of initiative is “to improve care and improve health for Medicaid beneficiaries and reduce costs by supporting states in accelerating new payment and service delivery reforms.”

The letter announcing the initiative holds up three examples of state innovation success in Ohio, Washington and North Carolina. Here’s what it has to say about North Carolina: Read More

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The mayor of a small coastal town with a recently-shuttered rural hospital began a nearly 300 mile walk to Washington, D.C. to call attention to his community’s lack of emergency medical care.

Belhaven Mayor Adam O'Neal  (Photo by Adam Linker)

Belhaven Mayor Adam O’Neal
(Photo by Adam Linker)

Adam O’Neal, the Republican mayor of Belhaven on North Carolina’s Inner Banks, began his walk after a brokered plan with Vidant Health to keep the Pungo District Hospital open fell apart last month. He’s expected to arrive in Washington in two weeks.

The nearest hospital and emergency care to the Beaufort County town is now in Greenville, nearly 50 miles and an hour’s drive away from Belhaven.

O’Neal has partnered with the N.C. NAACP to call for both Medicaid expansion and for the Belhaven hospital to stay open.

Vidant Health officials, when it initially announced its plan to close the hospital, said the N.C. legislature’s decision to not expand Medicaid meant the hospital wouldn’t be able to afford to stay open with a large segment of uninsured residents.

The Carolina Mercury posted this article today about O’Neal’s march, and included a letter from the mayor about the reasons behind the march.

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