At a forum this week, the state Secretary of Health and Human Services pushed providers to advocate for accountable care organizations to their local lawmakers.
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By Jen Ferris
In the upcoming legislative session, the North Carolina General Assembly must pass a new Medicaid plan, one that utilizes accountable care organizations, Department of Health and Human Services Sec. Aldona Wos said Tuesday.
Speaking at Community Care of North Carolina’s Innovation Forum held at the McKimmon Center on the NC State University campus, Wos called on attendees to champion ACOs as the health care solution that would preserve doctors’ ability to treat patients.
ACOs are one of two competing methods lawmakers have considered to reform the state’s system to provide health and mental health care for low-income individuals, families, seniors and people with disabilities.[pullquote_right]Want to know more about accountable care organizations? An ACO in Greensboro has found success with the model, but not without some difficulty.[/pullquote_right]“This is for the bigger good,” Wos said, referring to her proposed plan, which relies on ACOs for Medicaid management.
Wos has been pushing for ACOs since last year, when a panel appointed to recommend the future shape of Medicaid came down in favor of ACOs: partnerships of health care providers that agree to set a budget for patient care. By doing so, doctors and hospitals share the financial risk of Medicaid with the state, instead of, as Wos said, leaving the state solely responsible for increasing health care costs.
“We all know we have to watch the money. We have to be true not only to the citizens that we take care of and we serve in our population, we have to be true to the taxpayers that are paying for this. And the only way we can do that [is] if we have an ability to honestly, ourselves, manage the cost.”
The idea of using ACOs to run Medicaid has found a mixed reception in the General Assembly. During the 2014 budget session, the House of Representatives unanimously passed a bill that approved the use of ACOs, while the Senate was in favor of an alternate system that would open the door for private managed care organizations to reduce the state’s Medicaid spending.
This disagreement between the two legislative chambers over the shape of Medicaid delayed adjournment of the General Assembly last summer.
Since that time, the federal government has continued to promote the ACO model, approving 89 more organizations nationwide to its roster of those that experts say reduce spending and increase patient health in the Medicare program, which mostly covers seniors.
It’s likely Wos will face an uphill battle in her push to shift the state Medicaid system to ACOs. As recently as December, state lawmakers approved a subcommittee report that could leave the door open to MCOs.
“I ask at this point you all continue to advocate and become more vocal of your support of the ACO model,” Wos told almost 300 doctors, medical administrators and policymakers at Tuesday’s forum. “This allows heath care to do what is best, and what is best is to provide proper care for our patients.”
As the General Assembly prepares to begin its session Wednesday, Wos said she feels certain of her ability to bring a reform bill to lawmakers that will be approved both in the House and Senate before session’s end.
“At the end of the day, it did pass the House unanimously and bipartisanly,” Wos said, referring to the 2014 bill that advocated the use of ACOs. “That’s something that’s unique, to get that far. I firmly believe that we can do it, that we can get it over the finish line.”