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Policy Report Lessons Learned: How the Partnership for a Healthy North Carolina Avoids Kentucky’s Medicaid Reform Mistakes

Policy Report Lessons Learned: How the Partnership for a Healthy North Carolina Avoids Kentucky’s Medicaid Reform Mistakes

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Governor Pat McCrory’s Partnership for a Healthy North Carolina is an innovative approach to redesign the state’s Old Medicaid system into a safety net that improves patients’ health and saves taxpayer dollars.

The Partnership builds upon powerful patient-centered reforms already working in other states. Key features of the Partnership—patient choice, competition among private plans, funding strategies that prioritize patient health, and streamlined billing systems—are succeeding in Florida, Kansas, and Louisiana.

The McCrory administration wisely embraced proven strategies to develop the Partnership. But it also paid close attention to why managed care reform efforts faltered elsewhere, particularly in Kentucky.

In 2011, Kentucky transitioned to a statewide Medicaid managed care program. Unfortunately, an ill-conceived implementation timeline and the absence of key provisions resulted in several complications for patients, providers, and policymakers. These include:

• Senseless administrative burdens afflicting providers’ abilities to practice efficiently

• Lengthy payment delays to doctors and hospitals

• Poor implementation strategies resulting in failed development of provider networks

This report examines these and other mistakes that left Kentucky with a botched Medicaid reform. It also explains the strategies and provisions included in the Partnership for a Healthy North Carolina that help to ensure North Carolina’s patient-centered Medicaid reform does not replicate Kentucky’s failings.

Governor Pat McCrory’s Partnership for a Healthy North Carolina is an innovative approach to redesign the state’s Old Medicaid system into a safety net that improves patients’ health and saves taxpayer dollars.

The Partnership builds upon powerful patient-centered reforms already working in other states. Key features of the Partnership—patient choice, competition among private plans, funding strategies that prioritize patient health, and streamlined billing systems—are succeeding in Florida, Kansas, and Louisiana.

The McCrory administration wisely embraced proven strategies to develop the Partnership. But it also paid close attention to why managed care reform efforts faltered elsewhere, particularly in Kentucky.

In 2011, Kentucky transitioned to a statewide Medicaid managed care program. Unfortunately, an ill-conceived implementation timeline and the absence of key provisions resulted in several complications for patients, providers, and policymakers. These include:

• Senseless administrative burdens afflicting providers’ abilities to practice efficiently

• Lengthy payment delays to doctors and hospitals

• Poor implementation strategies resulting in failed development of provider networks

This report examines these and other mistakes that left Kentucky with a botched Medicaid reform. It also explains the strategies and provisions included in the Partnership for a Healthy North Carolina that help to ensure North Carolina’s patient-centered Medicaid reform does not replicate Kentucky’s failings.

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Published by: John Locke Foundation on Jul 10, 2013
Copyright:Attribution Non-commercial

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11/06/2013

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How the Partnership for a Healthy North Carolina Avoids Kentucky’s Medicaid Reform Mistakes
Lessons Learned
 
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3 Executive Summary 4 Overview Learning from other states 5 The Partnership for a Healthy North Carolina reduces administrative  burdens aficting Kentucky providers 6 The Partnership avoids the payment delays Kentucky providers face 7
 Louisiana’s Bayou Health protects providers from payment delays
 The Partnership develops strong provider networks through thoughtful implementation 8 The Partnership features leadership with the critical experience Kentucky lacked The Partnership helps ensure managed care organizations cannot hold the state hostage like they can in Kentucky 9 Conclusion10
E
nd Notes14 About the Authors15 About the John Locke Foundation
This is a joint publication of the Florida-based Foundation for Government Accountability and the North Carolina- based John Locke Foundation. It appears as Policy Brief #7 for the Foundation for Government Accountability’s Medicaid Cure initiative, and as a Policy Report for the John Locke Foundation.The views expressed in this report are solely those of the author and do not necessarily reect those of the staff or board of the John Locke Foundation. For more information, call 919-828-3876 or visit www.JohnLocke.org.©2013 by the John Locke Foundation.
 
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LESSONS LEARNEDPOLICY REPORT
 
Executive Summary
Governor Pat McCrory’s Partnership for a Healthy North Carolina is an innovative approach to redesign the state’s old Medicaid system into a safety net that improves patientshealth and saves taxpayer dollars.The Partnership builds upon powerful patient-centered reforms already working in other states. Key features of the Partnership—patient choice, competition among private plans, funding strategies that prioritize patient health, and streamlined billing systems—are succeeding in Florida, Kansas, and Louisiana. The McCrory administration wisely embraced proven strategies to develop the Partnership. But it also paid close attention to why managed care reform efforts faltered elsewhere, particularly in Kentucky.In 2011, Kentucky transitioned to a statewide Medicaid managed care program. Unfortunately, an ill-conceived implementation timeline and the absence of key provisions resulted in several complications for patients, providers, and policymakers. These include:Senseless administrative burdens aficting providers’ abilities to practice efcientlyLengthy payment delays to doctors and hospitalsPoor implementation strategies resulting in failed development of provider networksThis report examines these and other mistakes that left Kentucky with a botched Medicaid reform. It also explains the strategies and provisions included in the Partnership for a Healthy North Carolina that help to ensure North Carolina’s patient-centered Medicaid reform does not replicate Kentucky’s failings.

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