Wos: Medicaid reform to be tailored for NC

Posted November 7, 2013

— Secretary of Health and Human Services Aldona Wos said Thursday that she expects to have a Medicaid reform plan outlined by March that meets North Carolina's specific needs.

In an exclusive interview with WRAL News, Wos also placed some of the blame for the troubled launches of two computer systems at the feet of counties and the media, and she defended hiring and compensation decisions that have been widely criticized in recent months.

Cost overruns in the state's $13 billion Medicaid program have caused budgeting problems for lawmakers for years. The legislature was forced to come up with about $500 million to bail out the program during the fiscal year that began July 1.

Wos and Gov. Pat McCrory have been looking in recent months at moving to a managed care model that would pay a group of providers a flat fee for each of the 1.6 million North Carolinians served by the health care program and would shift any profit or loss in providing that care off the state budget and onto the companies' books.

"We have to figure out how to make it sustainable, figure out how to balance the budget and figure out how to make it all work," Wos said. "These are not easy issues."

The final system will be tailored to North Carolina, she said, noting that the state's needs are too unique to try to use another state's Medicaid system as a template. Even within North Carolina, needs vary from east to west, she said.

"We're creating a database solution that will be specific to North Carolina," she said.

DHHS Secretary Aldona Wos and WRAL anchor David Crabtree Web only: Interview with DHHS Secretary Wos

Still, DHHS officials are looking at what other states are doing to respond to certain situations to determine if programs elsewhere could be applied to North Carolina, Wos said.

"What's on the ground that's working already?" she said.

Two computer systems DHHS rolled out this summer both involve the Medicaid system. NCTracks handles claims and payments for health care providers, while NC FAST last month started handling people's enrollment in the program under the Affordable Care Act. NC FAST also enrolls people in other social service programs, such as food stamps.

Providers have complained about delays in getting paid for services to Medicaid patients and about difficulties in getting questions answered. Some needy families also said they had to go months without food stamps because of glitches with NC FAST.

Wos said she has no regrets about launching either system, both of which have been in development for years.

"It is a learning process," she said. "We're making herculean efforts daily – daily – to get to where we need to be."

The problems wouldn't have been as great, she said, if all counties had devoted extra personnel to handle the shift from paper-based systems to electronic ones. Also, she said, media coverage of the issue then produced a flood of calls from concerned people, which diverted staff from their normal duties.

"There are multiple things that appear that one cannot predict," she said.

DHHS is North Carolina's largest state agency, with more than 18,000 employees. Almost one-tenth of the workforce has turned over since Wos took charge in January.

"It's the nature of a large organization – people come, people go," she said. "If you're not standing still, you continue to change."

Some of the changes have raised eyebrows both publicly and among lawmakers. Some of McCrory's former campaign aides, for example, now hold well-paid jobs in the agency, and an executive on leave from Wos' husband's firm was hired as a consultant.

Wos declined to specifically address those situations, saying only that DHHS has a wide range of needs and is trying to find the best people for the job.

When asked how she would respond to school teachers who earn a fraction of what some of her consultants and new hires make, she returned to the need for Medicaid reform, saying the state would have money to give teachers raises if Medicaid didn't repeatedly drain the state's coffers.


This blog post is closed for comments.

Oldest First
View all
  • Come On_Seriously Nov 14, 2013

    "The problems wouldn't have been as great, she said, if all counties had devoted extra personnel to handle the shift from paper-based systems to electronic ones."

    So in other words, the problems would have been less if the also-cash-strapped counties had spent more to take up her slack.

    Well sure, everyone's job would be easier if you can get someone else to do it for you. See Tom Sawyer as example.

  • TTDD Nov 11, 2013

    Too much fraud and people on the system that do not really need it. Free loaders is what they are. It has no value to them because they feel a need of entitlement. Our hard working teachers amongst others who do not get paid what they are worth to support the lazy. Plus, the principals and superintendents are way overpaid for what they do.

  • TruDat Nov 11, 2013

    I don't trust Lady Wos and The Gang That Can't Shoot Straight to privatize Medicaid. They can't get anything right.

  • humm61 Nov 10, 2013

    How much are we paying for her to have two bodyguards so she doesn't have to answer any questions from the people who have to pay for the department she is mismanaging?

  • SisterChristian Nov 9, 2013


  • wildpig777 Nov 9, 2013

    Her incompetence is only exceeded by her arrogance. Which, sadly, is typical of most of McCrory's appointees.


    I second your post--- was mc this incompetent in charlotte? I mean the man was re-elected like 7 times. what happened I mean he comes to Raleigh and falls flat on his face............

  • TruDat Nov 9, 2013

    What will it take to make Wos one of those 10%?

  • free2bme Nov 8, 2013

    Wos should be forced to resign. She does not know what she is doing. She and her campaign workers are running DHHS into the ground.. The sad part is that the elderly, children, and the disabled suffer because of an incompetent uncompassionate Governor and his campaign donors.

  • ILoveDowntownRaleigh Nov 8, 2013

    Thanks for the link, HeadsUp.

    Wow, this Pope/McCrory/Wos mess gets bigger every day!

    NC Policy Watch reports that Ricky Diaz, the 24-year-old recent college grad and McCrory campaign assistant who now works at DHHS for $85,000, has been given a staff of 24 public relations specialists to manage! And both Wos and McCrory refuse to divulge what salaries are being given to these 24 assistants! And Mr. Pope? He keeps signing those checks!

  • HeadsUp Nov 8, 2013

    Great editorial column on Idunna Wos's mismanagement: