WRAL Investigates

Wake agency pushes Medicaid: 'We want them to stay on'

Posted August 20, 2012
Updated August 21, 2012

WRAL Investigates

— North Carolina spends $12 billion each year in federal Medicaid money, which provides everything from pregnancy care to counseling for low-income residents. In the midst of government cuts, the WRAL Investigates team found Wake County Human Services staff making a push to increase the Medicaid rolls.

Wake County held training for human services staff last week, which WRAL Investigates attended, and the directive was clear – everyone in the agency should identify people in the community who are eligible for the low-income government insurance. The training will continue sporadically over the next few weeks.

“We want them to get on Medicaid. We want them to stay on,” said Medicaid trainer Betsy Moore. “We see this as a benefit to the client and, in turn, it is a benefit for us.”

A training memo stated that Medicaid is everybody's business and encouraged staff to help increase the agency’s revenue.

“We’re just wanting our staff to have the conversation,” said Liz Scott, Medicaid program manager for Wake County Human Services. “They may be the only person from our agency that's interacting with that client.”

Scott says the new push to enroll eligible people is twofold. First, insurance coverage can help get low-income clients on a healthier road that includes a primary care physician and preventive medical treatment.

“Part of the focus is not just to enroll people in Medicaid, but also to educate clients on having a medical home,” she said.

Wake County pushes to increase Medicaid rolls Wake County pushes to increase Medicaid rolls

Second, it can bring more money into the agency. “There is the potential to lose revenue, and so, this is a strategy,” Scott said.

The reason, Scott says, is because the state has started shifting from a "fee for service" system, where Medicaid reimburses providers for every visit, to what is called a "per member per month" plan.

Wake County Human Services officials say the funding change could result in a $1 million Medicaid revenue loss per year for the agency. Leaders hope that adding eligible clients to the government insurance plan will recoup about half of that potential cut.

Fiscal YearWake Human Services BudgetWake Human Services Medicaid Revenue

Currently, mental health, child services and pregnancy care are transitioning to the more managed care system. The goal is to create a medical home with a continuity of care. The pregnancy program, for instance, is producing healthier mothers and babies at reduced costs, according to Scott.

There's also incentive for providers. The more people registered with Medicaid, the more revenue flows to places such as Wake Human Services to provide care.

“Our interest is, we want anyone who is Medicaid eligible, we want to make sure they are connected to a primary care physician and that we are really managing their health care and managing those very scarce taxpayer dollars,” said Rep. Nelson Dollar, R-Wake, who chairs the House Appropriations Committee on Health and Human Services.

The legislator says Wake County's effort to reach out to clients makes sense. He acknowledges it will increase the Medicaid rolls, but says as long as fraud is weeded out fewer dollars will be spent.

“We would rather have them in the system and have their health care properly managed, than to have people simply flooding into the emergency room,” Dollar said.


This story is closed for comments.

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  • censorbait Aug 22, 2012

    We are becoming a nation of deadbeats.

  • jetset Aug 21, 2012

    @ Boneymaroney 13---- yes, they do get recognition for the number they enroll! So, yes, DHHS pushes people to be on Medicaid and STAY om Medicaid. Sickening.......where is Renee Elmers?????L

  • boneymaroney13 Aug 21, 2012

    Once you get'em on these free programs, you never get'em off!!!

  • boneymaroney13 Aug 21, 2012

    And I bet she gets a hefty raise for her eagerness!!!

  • smokeybear Aug 21, 2012

    this is such as sad country we live in.

  • storchheim Aug 21, 2012

    "There is no one legitimately on Medicaid that is out whooping it up on tax dollars." lalaloo

    Key word = 'legitimately'.

  • loving life 84 Aug 21, 2012

    This is not fair to the people who work and have to pay out of their pockets for healthcare, and end up with a moutain of medical billS, collection notices from medical bills, and our tax money pays for someone that can sit on their BEHIND all day and get medicaid, and be debt free of medical bills... NO THEY NEED TO PAY JUST LIKE EVERBODY ELSE. A person should not be able to get something out of something they did not put into POINT BLANK.

  • indrdw Aug 21, 2012

    Yes you can't have anything and can't have more than $2000 in the bank. A lot of us folks that have worked all our lives, have a little bit of something and have insurance can't afford to use it because of co-insurance and co-pays. No need in going for a wellness check that it will pay for when in the end you find you need some other medical attention. Maybe we should just give everythng away, do like 'some' people and never lift a finger to help ourselves. I know some people have come upon hard times but some people have lived off the taxpayers all their lives. It is a family value.

  • ospreysilver Aug 21, 2012

    $12 Billion on Medicaid (not Medicare) each year seems like enough to buy the state of NC. Its like the 30K a year to house each inmate in prison each year stat published a while back.

  • Marty King Aug 21, 2012

    What a waste of taxpayer money... why should we pay for the birthing of children for people who can't afford to have them in the first place?

    If you want a baby, pay for it yourself.