@NCCapitol

@NCCapitol

Medicaid advisory group hears from public

Posted January 15

Hugh Tilson, senior vice president with the N.C. Hospital Association

— One month after the state Medicaid Reform Advisory Group held its first meeting, the five-member panel reconvened on Wednesday – this time to hear from the public.

Doctors, Medicaid beneficiaries and other stakeholders packed the State Archives. Most of those who spoke said they have serious reservations about privatizing the system and putting managed care companies in charge.

“It has been our experience that managed care ultimately always fails because it’s a model that puts an administrator between a patient and a doctor,” said Dr. Rosemary Stein.

“They’re going to siphon 15 to 20 percent of these scarce Medicaid dollars out of the care for the people and into what they have to do, which is return money to their investors,” Hugh Tilson, senior vice president with the North Carolina Hospital Association added. “So, we think the better way to build the system is to build on what’s working in North Carolina, what’s already being developed, which is provider-led care about the patient, led by physicians and other competent professionals to make sure we’re focusing on the patient, not on profits.”

The five-member advisory group will gather Wednesday’s input and work with the state Department of Health and Human Services as it develops a Medicaid reform proposal to be unveiled in two months to the legislature. The advisory group’s third and final public meeting is scheduled for next month, although the exact date has not been released.

The health care system for about 1.6 million poor and disabled people in North Carolina accounts for about $13 billion in state and federal spending. Gov. Pat McCrory and Republican legislative leaders have blamed out-of-control costs for not providing teachers and state workers with a raise last year.

Reform means re-evaluating which Medicaid services should be provided, who should be eligible and how to consolidate the divide between mental and medical care.

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  • blueridgepics Jan 20, 5:02 p.m.

    By not extenibg Medicaid, North Carolina looses 5.7 billion dollars, that's $5,700,000,000.00.
    No state would experience a positive flow of funds by choosing to reject the Medicaid expansion. Because the federal share of the Medicaid expansion is so much greater than the state share, taxpayers in non-­participating states will nonetheless bear a significant share of the overall cost of the expansion through federal tax payments—and not enjoy any of the benefits.

    Contact Governor McCrory today.

  • blueridgepics Jan 20, 4:51 p.m.

    Our Governor turned down this deal for our citizens:
    Medicaid is usually a cost-sharing program – the federal government pays on average about 57 percent of costs and states pay the rest. But under the expansion, the federal government will pay 100 percent of the additional costs for the first three years. States will have to kick in a very small percentage more each year after that. By 2020, the federal government will pay 90 percent of the costs.

    Next time vote democrat.

  • caronia49 Jan 20, 2:38 p.m.

    Yes, to Thomasew52....The people who are paying for Medicaid, are the people who are getting ripped off.....and yes, there is something seriously wrong in our Country...Obama and the Democrats, who what the working people to pay more.....and could care less about these people..Thank you Kay Hagan, and your idol, Obama...

  • ccsmith1902 Jan 18, 5:10 p.m.

    McCrory wants the profits.

  • sixnitepkg Jan 18, 3:20 p.m.

    @ 99percenters - "Medicaid fraud is typically the service providers..."

    your claim is baseless - a few cases of abuse & billing fraud amongst thousands & thousands of doctors does not qualify as "widespread fraud" - you seem to think nearly every doc who sees medicaid patients is ripping the taxpayers off, &That's just not true!

    "how about the billing from the ER staffs" $700 for a pair" (of crutches)

    the reason insured patients pay more is that ER's HAVE to see indigent & medicaid patient's for nothing or nearly nothing. AND, remember this - you're also paying for that nurse, not only for your care but also to care for patient's on medicaid. RN's do NOT bill ANY insurer for their time & the hospital has to get $$ to pay them too!

    "so I disputed with my company insurance so they could dispute the charge," - and well you should, but trust me, medicaid doesn't need that - it pays a flat rate for an ER visit, and it doesn't matter if it's a stubbed toe or a heart attack!

  • lmatthews1948 Jan 18, 6:51 a.m.

    I hate it when news reports like this do not give you enough information to become involved. Two of the 5 members are Republicans in the General Assembly. Let them know how you feel about expanding Medicaid with money that is now going to other states. Let's take care of our own.

    The five committee members are: Chair, Dennis Barry of Guilford County, CEO emeritus of Cone Health; Peggy Terhune of Randolph County, executive director/CEO of Monarch, a behavioral health non-profit; Richard Gilbert, MD, MBA of Mecklenburg County, an anesthesiologist, who serves as chief of staff for Carolinas Medical Center; Rep. Nelson Dollar (R-Wake County); and Sen. Louis Pate (R -Lenoir, Pitt and Wayne counties).

  • AliceBToklas Jan 17, 3:38 p.m.

    The managed care model has been a failure since its inception several years back. They've managed to destroy good organizations and drive many people away from providing services for the most in need in our communities. I really hope that some good can come of all of this.

  • thomasew52 Jan 17, 12:48 p.m.

    It's amazing how many worry about the free services, and nothing for the working folks.

    — Posted by lisaclark2

    Thanks for your post, no one does care about the working folks, as long as they keep working for the freeloaders to have their freebies, and as long as they keep their mouths shut about it. Something has gone seriously wrong in our state/country, and nothing is being done about it. Instead, the ones paying for the freebies keep being asked to do more, and pay for more stuff.

  • GOPtakersSociety Jan 17, 8:41 a.m.

    "seems someone is afraid of losing complete control on how they bilk Medicaid! ." 99percenters
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    — Posted by sixnitepkg

    Disagree, Medicaid fraud is typically the service providers, liker the couple that bilked Medicaid for the wheelchairs a few years back, and how about the billing from the ER staffs, I'm not on Medicaid but went to the ER for my knee after injuring it and sat there in a room, not complaining, there were more serious patients, I asked for a knee brace and they offered crutches, I told them no I have some, the billed showed $700 for a pair...I disputed with mu company insurance so they could dispute the charge, Medicaid patients don't see their bills!

  • nic Jan 17, 8:22 a.m.

    "seems someone is afraid of losing complete control on how they bilk Medicaid! ." 99percenters
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    — Posted by sixnitepkg

    Couldn't have said it better!

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