Local Politics

Year after launch, NCTracks still getting mixed reviews from medical providers

Posted July 1, 2014
Updated July 2, 2014

— One year after the troubled launch of North Carolina's new half-billion-dollar Medicaid billing system, the state's health department says the system is effectively paying medical providers for patient treatment.

But not everyone is pleased with the progress of NCTracks, a complex technology project meant to streamline reimbursement to providers and make it easier for policy-makers to track Medicaid costs. Some doctors, clinics and other providers say they're still having trouble getting the money they're owed.

While state officials acknowledge there were issues when providers began using NCTracks on July 1, 2013, they say the system is working well and is a vast improvement over its 35-year-old predecessor.

“We went from a system that was very paper-based – lots and lots of paper forms – to now a system that is almost totally electronic,” Joe Cooper, chief information officer for the state Department of Health and Human Services, said. “A lot of progress has been made, and we feel very good about where we are.”

Jacob Rodman, of the Raleigh Neurosurgical Clinic, says that, although there's no doubt NCTracks has gotten better in the last year, the state still has “a long way to go.”

“It is not fixed,” Rodman said. “I think as far as ease of use for providers as it stands today, the consensus is the old system was better.”

The challenges with the system have been frustrating for other providers, such as Tonia LaRouche, of Health Innovations Pharmacy. In August, she told WRAL News the state owed her practice at least $30,000.

That amount is now down to just thousands for the small practice in Southern Pines, but the improvements haven't been universal.

“My biggest frustration is that I can't keep up with day-to-day operations because of this,” LaRouche said late last month. “We're backlogged because we have other insurance companies that we have to deal with. Medicaid takes a whole lot of time because of every step you have to go through.”

Dr. Albertina Smith at Sunshine Pediatric For state-funded technology, failure a likely option

Rodman said he has nine open technical complaints waiting for resolution by Computer Sciences Corp., the company paid $484 million to develop NCTracks. The original 2009 contract for the project was for $265 million before a two-year extension approved in 2011 under Democratic Gov. Bev Perdue's administration.

State audits have been critical of those contracts and have also raised issues with the implementation of NCTracks under DHHS Secretary Aldona Wos, an appointee of Republican Gov. Pat McCrory.

NCTracks website, Medicaid claims system Audit: DHHS ill-equipped to handle troubles with Medicaid billing system

Five-and-a-half years later, DHHS officials say CSC has been fined $1.4 million for failing to deliver “certain levels of service.” Despite those penalties, Cooper said the company's “been a good partner” during the project, which has so far paid out more than $10.3 billion for 200 million claims, almost all of which are paid within a week.

“I remind people that we have 97,000 providers, and you would expect that there is always going to be a few people in 97,000 providers that still have issues,” Cooper said. “But as we get them, we address them very quickly.”

Cooper notes that among the criticisms, there are also plenty of positives, such as the $3 million the department says it saves taxpayers every month by using one streamlined system.

Some say they're happy with the changes.

In a video released by DHHS on Monday, several medical providers praised the performance of NCTracks.

“It allows me to provide the type of care for my patients that I'd like to provide for them,” Scott Jensen, an oral surgeon in Greensboro, said in the video. “We have money to help the business grow so we can continue to provide the services patients have come to expect.”

While acknowledging its rocky start, Chris Lonon, with Home Instead Senior Care in Monroe, said NCTracks has seen dramatic improvement over the last year.

“I wouldn't say by any means it was great at the beginning,” Lonon said in the video. “But it's so much better a system once they worked all that out. I don't think there would be anybody that would tell you it's not a better system.”

They also said NCTracks allows quick notification of billing errors, meaning they get paid much faster. Cooper said that's one of the signs the system is working the way it's supposed to.

“We are paying claims very effectively, very efficiently, and any provider out there that doesn’t feel right about how they’re being paid, I’d like them to reach out to me personally,” Cooper said.

Department of Health and Human Services, DHHS generic Doctors file suit against NC, call Medicaid billing system 'disaster'

He added that providers having trouble could call his office at (919)855-3000 for help.

Some doctors and other medical practitioners have gone beyond lodging complaints with the department and CSC. In January, a group of providers filed a class-action lawsuit against DHHS, CSC and two other companies involved with the project, claiming "NCTracks has been a disaster, inflicting millions of dollars in damages upon North Carolina’s Medicaid providers.”

Rodman worries that, if the Medicaid payment process doesn't improve, it may force some medical providers to avoid the frustration altogether.

“These are the sickest of the sickest,” Rodman said of his Medicaid patients. “These are the patients that need care, need guidance, need providers the most in our society, and if we get to a point where people stop accepting Medicaid patients or new Medicaid patients, that could be disastrous for the health care system of North Carolina.”

Editor's note: This story has been updated to include Department of Health and Human Services Chief Information Officer Joe Cooper's office number, as well as a link to the DHHS video interviewing providers. The video for this story was edited to remove a portion of an interview showing Cooper laughing after a segment overviewing a pending lawsuit by doctors against NCTracks. This section was removed at the request of DHHS officials, who argued it could be misinterpreted by viewers.


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  • Atheistinafoxhole Jul 2, 2014

    Duke University Health System will shell out $700 million, so will Boston-based Partners HealthCare; University of California, San Francisco will pay $150 million. Customers, such as New Hampshire’s Dartmouth-Hitchcock Medical Center are feeling the pinch. DHMC which implemented Epic last year at a cost of $80 million, expects a weak operating performance in 2012, partly because of expenses related to Epic.Partly, but not entirely. There is much more.

    You should read the actual article instead of reading some editorial of another article that includes references to yet another article. The link YOU provided is NOT Forbes.

  • 68_dodge_polara Jul 2, 2014

    Here you like Forbes?

    "Forbes also notes -- probably with some accuracy -- that hospitals with significant outlays for new electronic records systems will eventually pass those costs along to patients, contributing to the soaring costs of medical care in the U.S."


  • 68_dodge_polara Jul 2, 2014

    View quoted thread

    This all started from personal experiences with the epic software transitions. Everything takes longer and patients are suffering now not just the staff, it's really nothing to laugh at. It does erk me that the mainstream media is afraid to run any stories about this. Ask your doctor or a nurse how it's going. I've personally seen one Doctor quit because of epic and the reduction of time he was able to spend with patients.

  • Atheistinafoxhole Jul 2, 2014

    View quoted thread

    Hahaha! Conservative Crusader and Michelle Malkin as credible sources?

    Did you read the Malkin article and check the sources? The RAND report she refers to as "grossly overstated" is in the RAND article, but they notably leave out the value of the "overstatement."
    From RAND: "Officials at RAND said their new analysis did not try to put a dollar figure on how much electronic record-keeping had helped or hurt efforts to reduce costs."
    http://www.nytimes.com/2013/01/11/business/electronic-records-systems-have-not-reduced-health-costs-report-says.html?_r=1&She also fails to identify the "But while health IT experts and concerned citizens balk"

    Try the Forbes interview with Judy Faulkner, it addresses the half truths and incomplete analysis in the Malkin article.

    http://www.forbes.com/sites/zinamoukheiber/2013/05/15/a-chat-with-epic-systems-ceo-judy-faulkner/The other article is equally thin.

  • 68_dodge_polara Jul 2, 2014

    View quoted thread

    "The stimulus package also included penalties for doctors who don't adopt the new technology. Providers who don't install electronic records by 2014 will face reductions in their Medicare reimbursements."


  • 68_dodge_polara Jul 2, 2014

    View quoted thread

    ask and you shall receive.

    "The Washington Examiner's Lachlan Markay reports that Judith Faulkner, founder and CEO of Epic Systems Corp., has been awarded a seat on the 13-member Health Information Technology Policy Committee, an Obamacare board charged with recommending how $19 billion in stimulus money gets spent on healthcare IT systems."

    "Faulkner has voiced opposition to Obama's policy of multivendor "interoperability," an idea that many different IT providers can integrate their products and software into a nationalized system. Faulkner has said that she supports a single vendor, stand-alone system because multiple vendors won't work."



  • iopsyc Jul 2, 2014

    View quoted thread

    It's kind of a no win situation. Launch a bad product, it fails, and then you get blamed for launching it and causing problems. Don't launch it in favor of creating a good product and you get blamed for wasting time and money.

  • Listen2MeNowHearMeLater Jul 2, 2014

    View quoted thread

    You can't truly be that dumb. This program was brought in by Purdue. It was simply executed by the current government.

  • iopsyc Jul 2, 2014

    View quoted thread

    Please provide evidence of your claim that providers are being "forced" to use Epic EHR software and that somehow it's tied to the current administration. Epic is one of several large EHR providers. They have won over many large hospital systems with their products and strategy. True, hospitals are grudgingly moving to EHRs, but they have choices in their software provider.

  • 68_dodge_polara Jul 2, 2014

    This is nothing compared to the Epic software fiasco occurring throughout the country as all medical providers are being forced use to this one software creating a monopoly. Billionaire Judy Faulkner is founder and CEO of Epic Systems and not surprisingly a heavy contributor to Democrats and especially to Obama.