Policy Brief #5: 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.