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From WRAL.com 1.22.12

RALEIGH, N.C. — Nearly $1 billion is still a big number in state government — except maybe for North Carolina’s Medicaid program.

Health and Human Services Secretary Lanier Cansler got some good news as he prepares to leave his job at the end of the month. The news was about cost savings associated with a nationally-recognized health care initiative for the state designed to manage better outcomes for Medicaid consumers.

An outside actuary estimated a cumulative $984 million in Medicaid savings from 2007 to 2010 from the nonprofit Community Care of North Carolina networks. The networks help 1.2 million patients with treatments for chronic and special conditions, ensure they aren’t overprescribed drugs and encourage them to go to a primary-care doctor, not the emergency room.

But with a projected $150 million Medicaid shortfall this year, a larger shortfall next year and a projected one-third increase in enrollees in 2014 because of the federal health care law, Cansler sounds justified in worrying about the overall Medicaid program’s long-term finances. For an agency that will spend almost $13 billion in federal and state funds this year, $1 billion over four years remain just one piece of the Medicaid savings puzzle.

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From the Progressive Pulse Blog 1.20.12

Up here in D.C. with all my fellow health advocates  I’m getting lots of questions about how we organize our Medicaid program in NC.  Why?  Well last month the national consulting firm Milliman came out with a report that put savings from our state’s Medicaid Community Care of NC program at nearly $1 billion.  The savings comes from better coordinating care by assigning people to medical homes.  They get the primary and preventive care they need, stay out of the emergency room and hospital and, not incidentally stay healthier.  The is government working at its best.  To learn more about the history and structure of Community Care NC check out the national toolkit – many other states are doing so because they want to do the same thing.

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From the Progressive Pulse Blog 1.20.12

Before turning over the reins at the end of this month, Secretary Lanier Cansler is offering a candid assessment of the challenges facing the North Carolina Department of Health and Human Services.

Cansler sat down with N.C. Policy Watch this week to defend the agency’s performance following a critical state audit, and he criticized Republicans legislators who reneged on an earlier pledge to help close a nearly $150 million gap in the state’s Medicaid program.

“I think the legislature wants to keep pressure on the administration to try to continue to squeeze the Medicaid program,” said Cansler, who is a Republican.

The Secretary notes after three years of cuts to the department, DHHS doesn’t have discretionary funding to shore-up the Medicaid program, which serves more than one million people statewide.

This latest shortfall follows a budget mandate by the N.C. General Assembly last summer that Health and Human Services eliminate another $350 million from its bottom line.

To view the video, click HERE.

From the Progressive Pulse Blog 1.20.11

Medicaid program staff released updated estimates of the current year’s Medicaid state funding shortfall as well as their estimate of next year’s shortfall at the monthly meeting of the Medical Care Advisory Committee. As has been reported elsewhere, the recent court order reinstating coverage of personal care services for adults with disabilities, the Division of Medical Assistance added $9.4 million in estimated expenses into the current year’s budget, driving the current year shortfall up to $149 million.

Next year’s estimated shortfall of $243 million will be driven by many of the same factors that created this year’s problem, according to DMA Chief Business Operating Officer Steve Owen. The legislature’s double-cut to program inflation – a measure built on expectations about changes to Medicaid that are beyond state administration’s control, such as federal changes and provider costs – shows up yet again as a confounding factor in an already cash-strapped budget.

The Medical Care Advisory Committee remains opposed to across-the-board provider reimbursement rate reductions, despite the fact that there are few budget reductions options beyond provider cuts left within the executive branch’s purview. Owen reminded attendees that states cannot run deficits and that DMA is working closely with OSBM to identify a solution that, presumably, won’t require legislative action.

As one committee member asked, what happens next? The answer: no one knows.

To link to this story, click HERE.